Provider Demographics
NPI:1578250163
Name:SORIA, MARILU (FNP)
Entity Type:Individual
Prefix:
First Name:MARILU
Middle Name:
Last Name:SORIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 OAKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3618
Mailing Address - Country:US
Mailing Address - Phone:646-267-8316
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4020
Practice Address - Country:US
Practice Address - Phone:516-489-6600
Practice Address - Fax:516-213-8909
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF351314-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily