Provider Demographics
NPI:1578661898
Name:BARRY, PAULA SOROKANICH (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:SOROKANICH
Last Name:BARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MCFARLAN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2479
Mailing Address - Country:US
Mailing Address - Phone:610-925-3835
Mailing Address - Fax:610-925-3834
Practice Address - Street 1:404 MCFARLAN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-2479
Practice Address - Country:US
Practice Address - Phone:610-925-3835
Practice Address - Fax:610-925-3834
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007213207R00000X
MD423236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000034767Medicaid
DE014193A60Medicare ID - Type Unspecified
DE1000034767Medicaid