Provider Demographics
NPI: | 1841929460 |
---|---|
Name: | SORIN MEDICAL PC |
Entity type: | Organization |
Organization Name: | SORIN MEDICAL PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ERICA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GOMEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 718-266-0900 |
Mailing Address - Street 1: | 8718 BAY PARKWAY |
Mailing Address - Street 2: | FLOORS1 AND 2 |
Mailing Address - City: | BROOKLYN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11214 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-266-0900 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 120 WALL ST STE 175 |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10005-3904 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-266-0900 |
Practice Address - Fax: | 718-266-1426 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-06-08 |
Last Update Date: | 2022-06-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
No | 202K00000X | Allopathic & Osteopathic Physicians | Phlebology | Group - Multi-Specialty | |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Multi-Specialty |
No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
No | 2471C1101X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Cardiovascular-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 | 2471V0106X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Vascular-Interventional Technology | Group - Multi-Specialty |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology |