Provider Demographics
NPI:1487812129
Name:POMONA SONO MEDICAL, PLLC
Entity type:Organization
Organization Name:POMONA SONO MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-414-6900
Mailing Address - Street 1:PO BOX 234894
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-4894
Mailing Address - Country:US
Mailing Address - Phone:516-414-6900
Mailing Address - Fax:516-393-6130
Practice Address - Street 1:26 FIREMANS MEML DR
Practice Address - Street 2:SUITE 120
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3553
Practice Address - Country:US
Practice Address - Phone:845-362-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197817173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY197817OtherLISCENS