Provider Demographics
NPI:1689725947
Name:SORIN, ROBERT M (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:SORIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 MADISON AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1110
Mailing Address - Country:US
Mailing Address - Phone:212-355-3533
Mailing Address - Fax:212-759-5696
Practice Address - Street 1:425 MADISON AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1110
Practice Address - Country:US
Practice Address - Phone:212-355-3533
Practice Address - Fax:212-759-5696
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032585-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice