Provider Demographics
NPI:1962431130
Name:BURGHER, SONIA Y (MD)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:Y
Last Name:BURGHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:A
Other - Last Name:BURGHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:76 S STATE ST
Mailing Address - Street 2:UNIT 2 C
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4851
Mailing Address - Country:US
Mailing Address - Phone:856-692-6000
Mailing Address - Fax:856-692-0609
Practice Address - Street 1:2950 COLLEGE DRIVE
Practice Address - Street 2:UNIT 2 C
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-692-6000
Practice Address - Fax:856-692-0609
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03650400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3993205Medicaid
NJ22-3133751OtherTAX ID NUMBER
NJD06942Medicare UPIN