Provider Demographics
NPI:1659448827
Name:SELECT CARE SOLUTIONS MEDICAL, P.C.
Entity Type:Organization
Organization Name:SELECT CARE SOLUTIONS MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-382-3400
Mailing Address - Street 1:454 AVENUE U
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4011
Mailing Address - Country:US
Mailing Address - Phone:718-382-3400
Mailing Address - Fax:718-382-3420
Practice Address - Street 1:717 BROADWAY # 727
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-3401
Practice Address - Country:US
Practice Address - Phone:718-382-3400
Practice Address - Fax:718-382-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05454200208100000X
NJ25MA067854002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty