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General NPI Number Information
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NPI Number | 1487089686
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Entity Type | Individual
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Provider Name | DHARA SONI PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 5 PERRYRIDGE RD
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City | GREENWICH
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State | CT
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Zip | 06830-4608
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Country | US
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Telephone | 630-200-2055
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Fax |
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Provider Business Mailing Address
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Address Line | 101 ROOSEVELT AVE 216
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City | CARTERET
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State | NJ
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Zip | 07008-2491
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Country | US
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Telephone | 630-200-2055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 016846
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 003116
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License Number State | CT
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