Provider Demographics
NPI:1649594946
Name:VINDHEIM, SONJA ALISE (DO)
Entity type:Individual
Prefix:DR
First Name:SONJA
Middle Name:ALISE
Last Name:VINDHEIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 UNQUOWA PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5014
Mailing Address - Country:US
Mailing Address - Phone:203-452-8322
Mailing Address - Fax:203-254-1058
Practice Address - Street 1:50 UNQUOWA PL
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5014
Practice Address - Country:US
Practice Address - Phone:203-452-8322
Practice Address - Fax:203-254-1058
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT053001208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics