Provider Demographics
NPI:1841509098
Name:PAUL SOREN ODPC
Entity type:Organization
Organization Name:PAUL SOREN ODPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOREN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-261-6000
Mailing Address - Street 1:6939 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4243
Mailing Address - Country:US
Mailing Address - Phone:718-261-6000
Mailing Address - Fax:
Practice Address - Street 1:6939 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4243
Practice Address - Country:US
Practice Address - Phone:718-261-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty