1043243033 NPI number — MS. WENDY SORBY M.S.W.

Table of content: MS. WENDY SORBY M.S.W. (NPI 1043243033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043243033 NPI number — MS. WENDY SORBY M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SORBY
Provider First Name:
WENDY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUSSMAN
Provider Other First Name:
WENDY
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.W.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1043243033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 HENRY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCARSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10583-2602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-472-0036
Provider Business Mailing Address Fax Number:
914-722-6727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 HENRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCARSDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10583-2602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-472-0036
Provider Business Practice Location Address Fax Number:
914-722-6727
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  PR002558-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: WS963 . This is a "OXFORD PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 216754 . This is a "MHN PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 363942 . This is a "MVP PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P11112603 . This is a "MULTIPLAN PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 135448 . This is a "VALUE OPTIONS PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4582707 . This is a "AETNA PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02037736 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10764-17806 . This is a "CMS PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 62-27877 . This is a "UNITED PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 749-3797 OR 0049001 . This is a "GHI PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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