Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 019973 | CT |
Y | 207VX0201X | Gynecologic Oncologist | MD-036887E | PA |
NPI | 1265410690 |
---|---|
Provider Name | Dr. Joel Sorosky |
First Address | Willow Grove, PA 19090-1104 |
Second Address | Willow Grove, PA 19090-1104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 26/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001199736 | (05) | CT |
B41389 | (02) | CT |