Provider Demographics
NPI:1386667749
Name:CARLO A SORANNO MD PC
Entity Type:Organization
Organization Name:CARLO A SORANNO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SORANNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-226-2600
Mailing Address - Street 1:53 HARRINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3397
Mailing Address - Country:US
Mailing Address - Phone:631-226-2600
Mailing Address - Fax:631-226-3027
Practice Address - Street 1:53 HARRINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-3397
Practice Address - Country:US
Practice Address - Phone:631-226-2600
Practice Address - Fax:631-226-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0805371208000000X
NY1709091208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4061686OtherAETNA
CP063OtherOXFORD
PA2772OtherHEALTH NET
10676OtherANTHEM
0015092OtherGHI
0070758001OtherAMRIHEALTH GROUP
0532079OtherAETNA US HEALTHCARE
OP208POtherHIP
080537A85OtherHEALTHFIRST
167628OtherAMRIHEALTH PPO POS
257051OtherBLUE CROSS
AG01296OtherMDNY
010080537NY01OtherBILLING ID#
0523936003OtherCIGNA PAL#
48468OtherAETNA US HEALTHCARE GROUP
62291607OtherATLANTIS
01087787OtherMEDICAID GROUP
0129885000OtherAMRIHEALTH HMO
00391539OtherMEDICAID
200444OtherCOMED