Healthcare Provider Details

I. General information

NPI: 1730258856
Provider Name (Legal Business Name): JONAS M SOKOLOF D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 38TH ST FL 15
NEW YORK NY
10016-2708
US

IV. Provider business mailing address

515 MADISON AVE 5TH FLOOR
NEW YORK NY
10022-5403
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-6037
  • Fax:
Mailing address:
  • Phone: 646-888-1934
  • Fax: 646-888-1910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number250127
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: