Basic Information
Provider Information
NPI: 1306264429
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINTO
FirstName: SONIYA
MiddleName: NAOMI
NamePrefix: DR.
NameSuffix:  
Credential: MBBS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1384 DUNLEITH DR APT 302
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381038966
CountryCode: US
TelephoneNumber: 6462750772
FaxNumber:  
Practice Location
Address1: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Address2: 262 DANNY THOMAS PLACE
City: MEMPHIS
State: TN
PostalCode: 381056062
CountryCode: US
TelephoneNumber: 9015953300
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/05/2014
LastUpdateDate: 07/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085D0003XA159383CAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging

No ID Information.


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