Provider Demographics
NPI: | 1942543053 |
---|---|
Name: | SORIN MEDICAL PC |
Entity Type: | Organization |
Organization Name: | SORIN MEDICAL PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOSEPH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PUMA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 718-266-0900 |
Mailing Address - Street 1: | 8718 BAY PKWY STE 1AND2 |
Mailing Address - Street 2: | |
Mailing Address - City: | BROOKLYN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11214-5272 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-266-0900 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8718 BAY PKWY STE 1AND2 |
Practice Address - Street 2: | |
Practice Address - City: | BROOKLYN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11214-5272 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-266-0900 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-03-27 |
Last Update Date: | 2022-06-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 165466 | 207Q00000X |
207RC0000X, 207RC0001X, 2085R0204X, 2086S0129X, 246X00000X, 246XC2903X, 2471C1106X, 2471S1302X, 2471V0105X, 374700000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
No | 246X00000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Group - Multi-Specialty | |
No | 246XC2903X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Vascular Specialist | Group - Multi-Specialty |
No | 2471C1106X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Cardiac-Interventional Technology | Group - Multi-Specialty |
No | 2471S1302X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Sonography | Group - Multi-Specialty |
No | 2471V0105X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Vascular Sonography | Group - Multi-Specialty |
No | 374700000X | Nursing Service Related Providers | Technician | Group - Multi-Specialty |