Provider Demographics
NPI:1316260946
Name:GAZTAMBIDE, SONIA (MPH)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:GAZTAMBIDE
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:VILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH
Mailing Address - Street 1:53 BRIARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53 BRIARWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2902
Practice Address - Country:US
Practice Address - Phone:860-216-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor