Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 262020 | NY |
NPI | 1295022168 |
---|---|
Provider Name | Yevgeniy Sorokin |
First Address | New York, NY 10006-2550 |
Second Address | New York, NY 10006-2550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2011 |
Last Update Date | 31/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03974022 | (05) | NY |