MEDICARE: MRS. KIMBERLY SONKIN THRUSTON MOT OTRL CHT

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	225XH1200X	Hand Occupational Therapist	0119002963	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00377986	OTHER	VA	MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649232570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY SONKIN THRUSTON MOT OTRL CHT

Provider Business Mailing Address
First Line	:	PO BOX 1583
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22902-1583
Country	:	US
Telephone Number	:	434-982-7794
Fax Number	:	434-982-7752

Provider Business Practice Location Address
First Line	:	410 ALBEMARLE SQ
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-7400
Country	:	US
Telephone Number	:	434-817-4278
Fax Number	:	434-817-4279

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	08/21/2008

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Directions to “ MRS. KIMBERLY SONKIN THRUSTON MOT OTRL CHT” Practice Location

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