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NPI Code Detail

MEDICARE: MR. JOSEPH PATRICK SONNENBERG M.S.

MEDICARE: MR. JOSEPH PATRICK SONNENBERG M.S.
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
1235Z00000XSpeech-Language Pathologist000058-1NY

General Provider Information

NPI Number : 1619921954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH PATRICK SONNENBERG M.S.
Provider Business Mailing Address
First Line : 6479 OLD LAKE SHORE RD
Second Line :
City : DERBY
State : NY
Zip : 14047-9731
Country : US
Telephone Number : 716-573-5710
Fax Number :
Provider Business Practice Location Address
First Line : 50 E NORTH ST
Second Line :
City : BUFFALO
State : NY
Zip : 14203-1002
Country : US
Telephone Number : 716-885-8871
Fax Number : 716-885-4229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/08/2007

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Directions to “ MR. JOSEPH PATRICK SONNENBERG M.S.” Practice Location

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