Provider Demographics
NPI:1639473267
Name:SONKIN, JILLIAN (FNP)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:SONKIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2700
Mailing Address - Country:US
Mailing Address - Phone:516-887-0077
Mailing Address - Fax:516-887-5365
Practice Address - Street 1:185 MERRICK RD
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2700
Practice Address - Country:US
Practice Address - Phone:516-887-0077
Practice Address - Fax:516-887-5365
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily