Provider Demographics
NPI:1912478561
Name:SOKOLOW MEDICAL OF PA PLLC
Entity Type:Organization
Organization Name:SOKOLOW MEDICAL OF PA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-997-6510
Mailing Address - Street 1:PO BOX 958
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-0811
Mailing Address - Country:US
Mailing Address - Phone:484-997-6510
Mailing Address - Fax:888-972-3585
Practice Address - Street 1:3477 CORPORATE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8237
Practice Address - Country:US
Practice Address - Phone:484-997-6510
Practice Address - Fax:888-972-3585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty