Doctor Name: | SONJA MARIE GEOURZOUNG |
NPI Number: | 1841430949 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 171160 |
Business Practice Address: | 90-37 Parsons Blvd Jamaica, NY - 11432 |
Business Phone Number: | 7182625533 |
Business Fax Number: | |
Mailing Address: | 133 W. Greenwich Ave., ROOSEVELT |
State: | NY |
Postal Code: | 11575 |
Phone Number: | 5163787216 |
Fax Number: | 5163787216 |
NPI Enumeration Date: | 03/02/2009 |
NPI Last Update Date: | 03/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 171160 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |