Healthcare Provider Details
I. General information
NPI: 1124033576
Provider Name (Legal Business Name): TOYOOKI SONODA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1315 YORK AVE 2ND FLOOR
NEW YORK NY
10021-5304
US
IV. Provider business mailing address
525 E 68TH ST MAILBOX 172
NEW YORK NY
10021-4870
US
V. Phone/Fax
- Phone: 212-746-6030
- Fax:
- Phone: 212-746-6030
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 220689 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 220689 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: