Provider Demographics
NPI:1073386314
Name:SORIANO, ANTONIO (LMT)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:SORIANO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PARK HILL AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4823
Mailing Address - Country:US
Mailing Address - Phone:914-562-9495
Mailing Address - Fax:
Practice Address - Street 1:94 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5085
Practice Address - Country:US
Practice Address - Phone:914-562-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033414225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist