Provider Demographics
NPI:1093797540
Name:SORIANO, EDWARD T JR (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:T
Last Name:SORIANO
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:525 ROUTE 73 S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-9642
Mailing Address - Country:US
Mailing Address - Phone:856-985-0800
Mailing Address - Fax:856-985-6331
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:PM&R
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-6585
Practice Address - Fax:410-601-9692
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-05-04
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB06306500208VP0014X
MDH0071373208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ079935Medicare ID - Type Unspecified
NJG77601Medicare UPIN
MDS588Medicare PIN
NJ010655Medicare ID - Type Unspecified