MEDICARE: SONIA LUGO

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1548992654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA LUGO

Provider Business Mailing Address
First Line	:	15916 UNION TPKE
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11366-1954
Country	:	US
Telephone Number	:	646-641-5355
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 E 131ST ST APT 5E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10037-2948
Country	:	US
Telephone Number	:	646-641-5355
Fax Number	:

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

Provider Enumeration Date	:	06/28/2022
Last Update Date	:	06/28/2022

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Directions to “ SONIA LUGO ” Practice Location

Language	Start Address	Practice Location

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