Basic Information
Provider Information
NPI: 1114244027
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOY
FirstName: SONIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 25 MEDWAY ST APT C
Address2:  
City: BOSTON
State: MA
PostalCode: 021245771
CountryCode: US
TelephoneNumber: 2812224562
FaxNumber:  
Practice Location
Address1: 301 BROADWAY
Address2:  
City: CHELSEA
State: MA
PostalCode: 021502807
CountryCode: US
TelephoneNumber: 6178894860
FaxNumber: 6178894635
Other Information
ProviderEnumerationDate: 05/02/2010
LastUpdateDate: 03/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804X277091MAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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