Provider Demographics
NPI:1912259375
Name:SORIANO, YURICO
Entity Type:Individual
Prefix:MISS
First Name:YURICO
Middle Name:
Last Name:SORIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 TEMBY DR
Mailing Address - Street 2:
Mailing Address - City:DOVER PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12522-5841
Mailing Address - Country:US
Mailing Address - Phone:914-258-7798
Mailing Address - Fax:
Practice Address - Street 1:301 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1636
Practice Address - Country:US
Practice Address - Phone:845-458-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NY031528235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator