MEDICARE: SONYA S WORTHY MED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1134401532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA S WORTHY MED

Provider Business Mailing Address
First Line	:	1 JASPER JOHNS WAY
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-7218
Country	:	US
Telephone Number	:	856-220-0144
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 E DURHAM ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-1823
Country	:	US
Telephone Number	:	856-220-0144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	09/13/2011

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Directions to “ SONYA S WORTHY MED” Practice Location

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