Basic Information
| Provider Information | |||||||||
| NPI: | 1366707812 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SONANI | ||||||||
| FirstName: | RUPALBEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1473 | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187040473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702085534 | ||||||||
| FaxNumber: | 5702085548 | ||||||||
| Practice Location | |||||||||
| Address1: | 575 N RIVER ST | ||||||||
| Address2: | FOURTH FLOOR | ||||||||
| City: | WILKES BARRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187640999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705524450 | ||||||||
| FaxNumber: | 5705524455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2012 | ||||||||
| LastUpdateDate: | 04/10/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 26550 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD459366 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MD459366 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.