Healthcare Provider Details

I. General information

NPI: 1417942210
Provider Name (Legal Business Name): NEIL B SOSKEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2005
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MERRICK RD
LYNBROOK NY
11563-2700
US

IV. Provider business mailing address

185 MERRICK RD SUITE 1B
LYNBROOK NY
11563-2700
US

V. Phone/Fax

Practice location:
  • Phone: 516-887-0077
  • Fax: 516-887-5365
Mailing address:
  • Phone: 516-887-0077
  • Fax: 516-887-5365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number172261
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: