Healthcare Provider Details

I. General information

NPI: 1316038730
Provider Name (Legal Business Name): VANDANA KEWEL SONI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 OLD COUNTRY RD SUITE 205
PLAINVIEW NY
11803-4932
US

IV. Provider business mailing address

700 OLD COUNTRY RD SUITE 205
PLAINVIEW NY
11803-4932
US

V. Phone/Fax

Practice location:
  • Phone: 516-932-8876
  • Fax: 516-822-3637
Mailing address:
  • Phone: 516-932-8876
  • Fax: 516-822-3637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number195928
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01672944
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: