Provider Demographics
NPI:1861472292
Name:SORIANO, JOHN G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:SORIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:404 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:16 POCONO RD
Practice Address - Street 2:STE 201
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2901
Practice Address - Country:US
Practice Address - Phone:973-627-4430
Practice Address - Fax:973-586-2336
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA044559174400000X
NJ25MA04455900207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1791907Medicaid
NJ1791907Medicaid
NJ571381A9SMedicare ID - Type Unspecified
NJ110027689Medicare PIN