Provider Demographics
NPI:1689790560
Name:DR.ALAN K.SOKOLOFF P.C.
Entity Type:Organization
Organization Name:DR.ALAN K.SOKOLOFF P.C.
Other - Org Name:YALICH CLINIC OF GLEN BURNIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SOKOLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:443-749-0001
Mailing Address - Street 1:331 OAK MANOR DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5508
Mailing Address - Country:US
Mailing Address - Phone:443-749-0001
Mailing Address - Fax:443-749-0011
Practice Address - Street 1:331 OAK MANOR DR
Practice Address - Street 2:SUITE 101
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5508
Practice Address - Country:US
Practice Address - Phone:443-749-0001
Practice Address - Fax:443-749-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01331111N00000X
MD20675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD101022OtherJHHC
DCE466OtherBSDC
6978412004OtherAHSN
MD204558300OtherMAMD
MD22281OtherALLIANCE
2736388OtherAETNA
MDDD0972OtherMBRR
MDS756ALOtherBSMD
MDS756Medicare PIN