Provider Demographics
NPI:1144322108
Name:SONI, SHIKHAR (MD)
Entity type:Individual
Prefix:
First Name:SHIKHAR
Middle Name:
Last Name:SONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 IRVING AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2716
Mailing Address - Country:US
Mailing Address - Phone:315-425-4400
Mailing Address - Fax:
Practice Address - Street 1:800 IRVING AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2716
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034743207L00000X
NY234901207L00000X, 207V00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010113016Medicaid
VA139715OtherANTHEM BCBS
MD002227600Medicaid
DC036195100Medicaid
DC666688OtherNCPPO
DC0154OtherCAREFIRST BCBS
DC3570662OtherAETNA HMO
DC242842OtherKAISER
DC7078554OtherAETNA NONHMO
I23264Medicare UPIN
DCP00184994Medicare ID - Type UnspecifiedRAILROAD MEDICARE
VA010113016Medicaid