Provider Demographics
NPI:1699097089
Name:WADHWA, SONIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:
Last Name:WADHWA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 PASCACK RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4235
Mailing Address - Country:US
Mailing Address - Phone:201-262-0520
Mailing Address - Fax:
Practice Address - Street 1:20 S KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2137
Practice Address - Country:US
Practice Address - Phone:201-930-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0503971183500000X
NJ28RI03031800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist