Provider Demographics
NPI:1639230691
Name:SORSCHER, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SORSCHER
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:BOX 1136
Mailing Address - Street 2:ONE GUSTAVE LEVY PLACE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-3400
Mailing Address - Fax:646-537-2299
Practice Address - Street 1:1450 MADISON AVE
Practice Address - Street 2:BOX 1136
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6508
Practice Address - Country:US
Practice Address - Phone:212-241-3400
Practice Address - Fax:646-537-2299
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381347363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8914508Medicaid
NY1639230691Medicaid
NJ064477Medicare PIN
NJP72642Medicare UPIN
NJ8914508Medicaid