1912953399 NPI number — SERGIO SOKOL M.D.,F.A.C.C.,P.C.

Table of content: (NPI 1912953399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912953399 NPI number — SERGIO SOKOL M.D.,F.A.C.C.,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERGIO SOKOL M.D.,F.A.C.C.,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912953399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 THIXTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEWLETT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11557-2631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-741-8599
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 CENTRAL AVE STE M
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDARHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11516-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-804-8590
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SOKOL
Authorized Official First Name:
SERGIO
Authorized Official Middle Name:
Authorized Official Title or Position:
CARDIOLOGIST
Authorized Official Telephone Number:
917-741-8599

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  205875 , 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: 1169513 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2589396 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 677P71 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7819289 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 010065003 . This is a "AMERICHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3654963 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4889089 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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