1053365783 NPI number — DR. SERGIO SALVATORE SORRENTINO M.D.

Table of content: AMARYLLIS RIVERA LCSW (NPI 1447959960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053365783 NPI number — DR. SERGIO SALVATORE SORRENTINO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SORRENTINO
Provider First Name:
SERGIO
Provider Middle Name:
SALVATORE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1053365783
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:
231 VIA MANZONI
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
ITALY
Provider Business Mailing Address Postal Code:
80122
Provider Business Mailing Address Country Code:
IT
Provider Business Mailing Address Telephone Number:
011393356642841
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 ERIE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HORNELL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14843-1909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-324-8255
Provider Business Practice Location Address Fax Number:
607-324-8774
Provider Enumeration Date:
05/19/2006

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: 2085R0202X , with the licence number:  167442 , 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: 00026402001 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00972752 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 167442 . This is a "NYS LICENSE #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MDH641 . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000922256001 . This is a "HEALTHNOW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 167442 . This is a "STATE INSURANCE FUND" identifier . This identifiers is of the category "OTHER".




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