Basic Information
Provider Information
NPI: 1154552339
EntityType: 2
ReplacementNPI:  
OrganizationName: ELIZABETH SONO MEDICAL PLLC
LastName:  
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Mailing Information
Address1: PO BOX 234640
Address2:  
City: GREAT NECK
State: NY
PostalCode: 110234640
CountryCode: US
TelephoneNumber: 6312771803
FaxNumber: 6315810015
Practice Location
Address1: 930 N WOOD AVE
Address2:  
City: LINDEN
State: NJ
PostalCode: 070364040
CountryCode: US
TelephoneNumber: 9089257400
FaxNumber: 6315810015
Other Information
ProviderEnumerationDate: 08/05/2009
LastUpdateDate: 08/05/2009
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: TERRANI
AuthorizedOfficialFirstName: MICHAEL
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AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6312771803
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101X197817NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

No ID Information.


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