Provider Demographics
NPI:1821033168
Name:SORANNO, CARL ANDREW (MD FAAP)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:ANDREW
Last Name:SORANNO
Suffix:
Gender:M
Credentials:MD FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HARRINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3397
Mailing Address - Country:US
Mailing Address - Phone:631-266-2600
Mailing Address - Fax:631-226-3027
Practice Address - Street 1:53 HARRINGTON AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-3397
Practice Address - Country:US
Practice Address - Phone:631-266-2600
Practice Address - Fax:631-226-3027
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1709091208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
010170909NY01OtherBILLING ID
48468OtherAETNA GROUP
CS078OtherOXFORD
OP207POtherHIP
170909A85OtherHEALTHFIRST
200409OtherCO MED
2601228OtherGHI
SF0000957OtherSELECT PRO WJ JONES
NY01073743Medicaid
4211133OtherAETNA
875354OtherPPO POS
AG01509OtherMDNY
000000068083OtherHMO
0532077OtherAETNA US HEALTHCARE
0577486002OtherCIGNA PAL
10677OtherANTHEM
20H461OtherBLUE CROSS
49099005OtherATLANTIS
OCO669OtherPHYSICANS HEALTH PHS
AG01509OtherMDNY