Provider Demographics
NPI:1720464217
Name:BAKER, SONJA THORSEN (PT)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:THORSEN
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 ROUTE 57 STE 5
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-3487
Mailing Address - Country:US
Mailing Address - Phone:908-852-5400
Mailing Address - Fax:908-852-5655
Practice Address - Street 1:1885 ROUTE 57 STE 5
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-3487
Practice Address - Country:US
Practice Address - Phone:908-852-5400
Practice Address - Fax:908-852-5655
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00878500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist