MEDICARE: MRS. SONIA BAWA OTR/L

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	225X00000X	Occupational Therapist	008936	NY

General Provider Information

NPI Number	:	1881903599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONIA BAWA OTR/L

Provider Business Mailing Address
First Line	:	5 STERLING CIR
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6300
Country	:	US
Telephone Number	:	631-935-4153
Fax Number	:	516-214-8499

Provider Business Practice Location Address
First Line	:	5 STERLING CIR
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6300
Country	:	US
Telephone Number	:	631-935-4153
Fax Number	:	516-214-8499

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

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	09/29/2010

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