Provider Demographics
NPI:1821056334
Name:SOOD, DINESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:DINESH
Middle Name:K
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 CLARENDON ST
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6930
Mailing Address - Country:US
Mailing Address - Phone:631-414-7274
Mailing Address - Fax:631-414-7273
Practice Address - Street 1:555 BROADHOLLOW RD
Practice Address - Street 2:SUITE #107
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-5078
Practice Address - Country:US
Practice Address - Phone:631-414-7274
Practice Address - Fax:631-414-7273
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2013-04-02
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Provider Licenses
StateLicense IDTaxonomies
NY1651452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01713840Medicaid
NY34F153Medicare PIN
NY01713840Medicaid