Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 193664 | NY |
NPI | 1003811167 |
---|---|
Provider Name | Dr. Paul Joseph Sorell III |
First Address | Commack, NY 11725-4427 |
Second Address | Huntington, NY 11743-3976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 04/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G27873 | (02) | NY |