Provider Demographics
NPI:1942377221
Name:SORIERO, SAMUEL J JR (DC PA)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:J
Last Name:SORIERO
Suffix:JR
Gender:M
Credentials:DC PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 KUSER RD
Mailing Address - Street 2:SUTIE A 1
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3828
Mailing Address - Country:US
Mailing Address - Phone:609-585-9095
Mailing Address - Fax:609-585-0936
Practice Address - Street 1:1540 KUSER RD
Practice Address - Street 2:SUTIE A 1
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3828
Practice Address - Country:US
Practice Address - Phone:609-585-9095
Practice Address - Fax:609-585-0936
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00191700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ461522Medicare ID - Type Unspecified