Provider Demographics
NPI:1083608442
Name:SORIAL, EHAB (MD)
Entity Type:Individual
Prefix:
First Name:EHAB
Middle Name:
Last Name:SORIAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:277 PLEASANT ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-235-5434
Mailing Address - Fax:508-235-5436
Practice Address - Street 1:277 PLEASANT ST
Practice Address - Street 2:SUITE 209
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-235-5434
Practice Address - Fax:508-235-5436
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA151686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59959Medicare UPIN
MAA23146Medicare PIN