Provider Demographics
NPI:1831147057
Name:SOKOLOW, SAUL KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:KENNETH
Last Name:SOKOLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 CROSSKEYS OFFICE PARK
Mailing Address - Street 2:FAIRPORT PEDIATRICS
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450
Mailing Address - Country:US
Mailing Address - Phone:585-223-6111
Mailing Address - Fax:585-223-0878
Practice Address - Street 1:460 CROSSKEYS OFFICE PARK
Practice Address - Street 2:FAIRPORT PEDIATRICS
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450
Practice Address - Country:US
Practice Address - Phone:585-223-6111
Practice Address - Fax:585-223-0878
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1351861208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics