Healthcare Provider Details

I. General information

NPI: 1154376499
Provider Name (Legal Business Name): PRABHAT SONI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 AVENUE O
BROOKLYN NY
11210-5230
US

IV. Provider business mailing address

2952 BRIGHTON 3RD ST STE 201
BROOKLYN NY
11235-7078
US

V. Phone/Fax

Practice location:
  • Phone: 718-787-1900
  • Fax: 718-787-0897
Mailing address:
  • Phone: 718-975-4334
  • Fax: 718-975-4337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number192569
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number192569
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number192569
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: