Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 266770 | NY |
Y | 111NI0900X | Internist | 266770 | NY |
NPI | 1003112954 |
---|---|
Provider Name | Ms. Deepthi Sara Sony |
First Address | Mount Vernon, NY 10550-4002 |
Second Address | Mount Vernon, NY 10550-4002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2011 |
Last Update Date | 11/06/2013 |