Healthcare Provider Details

I. General information

NPI: 1053365783
Provider Name (Legal Business Name): SERGIO SALVATORE SORRENTINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ERIE AVE
HORNELL NY
14843-1909
US

IV. Provider business mailing address

231 VIA MANZONI
NAPLES ITALY
80122
IT

V. Phone/Fax

Practice location:
  • Phone: 607-324-8255
  • Fax: 607-324-8774
Mailing address:
  • Phone: 011393356642841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number167442
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: