Provider Demographics
NPI:1285855080
Name:DELTREDICI, SONYA KLAW (MD)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:KLAW
Last Name:DELTREDICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 140
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5057
Practice Address - Country:US
Practice Address - Phone:717-741-8003
Practice Address - Fax:717-461-7404
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08236900207R00000X
PAMD434709207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA121037OtherGEISINGER HEALTH PLAN
PA2066647OtherHIGHMARK BLUE SHIELD
PA9198111OtherAETNA
PAP009797OtherGATEWAY
PA20079934OtherAMERIHEALTH MERCY-WMG
PA211502OtherJOHNS HOPKINS
PA50079326OtherCAPITAL BLUE CROSS
PA102180760Medicaid
PA247824OtherUNISON
MD934687OtherCAREFIRST MD BCBS
PAP009797OtherGATEWAY
PA102180760Medicaid