Provider Demographics
NPI:1568066751
Name:SOROKA, REGINA CLAIRE
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:CLAIRE
Last Name:SOROKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2919
Mailing Address - Country:US
Mailing Address - Phone:215-262-9156
Mailing Address - Fax:
Practice Address - Street 1:765 E COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-1207
Practice Address - Country:US
Practice Address - Phone:215-322-2443
Practice Address - Fax:215-322-5331
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043377L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist