Provider Demographics
NPI:1235266040
Name:SORIANO-BARTOLOME, NIDA GARCIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIDA
Middle Name:GARCIA
Last Name:SORIANO-BARTOLOME
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NIDA
Other - Middle Name:GARCIA
Other - Last Name:SORIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:134 NORTH AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7411
Mailing Address - Country:US
Mailing Address - Phone:914-637-0228
Mailing Address - Fax:914-637-9222
Practice Address - Street 1:134 NORTH AVE STE 13
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7411
Practice Address - Country:US
Practice Address - Phone:914-637-0228
Practice Address - Fax:914-637-9222
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0502321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice