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

Table of content: DR. SERGIO SALVATORE SORRENTINO M.D. (NPI 1053365783)

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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