Healthcare Provider Details

I. General information

NPI: 1558285734
Provider Name (Legal Business Name): SONALI GONDHULE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RIVER CT APT 2503
JERSEY CITY NJ
07310-2032
US

IV. Provider business mailing address

31 RIVER CT APT 2503
JERSEY CITY NJ
07310-2032
US

V. Phone/Fax

Practice location:
  • Phone: 929-256-0505
  • Fax:
Mailing address:
  • Phone: 929-256-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01184900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: