Provider Demographics
NPI:1861465403
Name:SORKIN, EVAN B (DC)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:B
Last Name:SORKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 OCEAN PKWY
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8367
Mailing Address - Country:US
Mailing Address - Phone:718-714-4650
Mailing Address - Fax:718-265-0345
Practice Address - Street 1:3000 OCEAN PKWY
Practice Address - Street 2:SUITE 2G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8367
Practice Address - Country:US
Practice Address - Phone:718-714-4650
Practice Address - Fax:718-265-0345
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01910214Medicaid
NY01910214Medicaid
NYU69365Medicare UPIN