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Individual

DR. SONAL PATHAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6045 KENNEDY BLVD, SUITE B, NORTH BERGEN, NJ 07047-3246
(201) 453-0322
(201) 453-0325
Mailing address
6045 KENNEDY BLVD, SUITE B, NORTH BERGEN, NJ 07047-3246
(201) 453-0322
(201) 453-0325

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25MA09178500
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
C1-0009164
DE
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051725
MEDICARE GROUP PTAN
NJ
01
25MA09178500
LICENSE
NJ
05
329461
NJ
Enumeration date
05/09/2009
Last updated
03/30/2016
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