Healthcare Provider Details

I. General information

NPI: 1639230691
Provider Name (Legal Business Name): MICHELLE SORSCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 MADISON AVE BOX 1136
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

BOX 1136 ONE GUSTAVE LEVY PLACE
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-3400
  • Fax: 646-537-2299
Mailing address:
  • Phone: 212-241-3400
  • Fax: 646-537-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number381347
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: