Provider Demographics
NPI:1942753751
Name:KASCHAK, SORAYAH GENEVIEVE (NP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SORAYAH
Middle Name:GENEVIEVE
Last Name:KASCHAK
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4115
Mailing Address - Country:US
Mailing Address - Phone:212-794-0800
Mailing Address - Fax:
Practice Address - Street 1:909 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4115
Practice Address - Country:US
Practice Address - Phone:212-794-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307891363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner