Provider Demographics
NPI:1275176620
Name:SONE HEALTH MEDICAL GROUP, PLLC
Entity type:Organization
Organization Name:SONE HEALTH MEDICAL GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:UBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-217-3005
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-0159
Mailing Address - Country:US
Mailing Address - Phone:860-744-2244
Mailing Address - Fax:860-744-2220
Practice Address - Street 1:55 HAZARD AVE
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3826
Practice Address - Country:US
Practice Address - Phone:860-744-2244
Practice Address - Fax:860-744-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1114397684Medicaid