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General NPI Number Information
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NPI Number | 1548992654
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Entity Type | Individual
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Provider Name | SONIA LUGO
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 56 E 131ST ST APT 5E
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City | NEW YORK
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State | NY
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Zip | 10037-2948
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Country | US
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Telephone | 646-641-5355
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Fax |
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Provider Business Mailing Address
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Address Line | 15916 UNION TPKE
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City | FRESH MEADOWS
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State | NY
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Zip | 11366-1954
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Country | US
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Telephone | 646-641-5355
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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