Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 33706 | AZ |
N | 2081P2900X | Pain Medicine | 33706 | AZ |
N | 2081S0010X | Sports Medicine | 33706 | AZ |
N | 213ES0000X | Sports Medicine | 33706 | AZ |
NPI | 1184645228 |
---|---|
Provider Name | Dr. Susan C. Sorosky |
First Address | Phoenix, AZ 85016-6534 |
Second Address | Phoenix, AZ 85016-6534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 14/04/2016 |