Healthcare Provider Details

I. General information

NPI: 1831610302
Provider Name (Legal Business Name): SUMIT SOHAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 9TH AVE
ALTOONA PA
16602-2415
US

IV. Provider business mailing address

1414 9TH AVE
ALTOONA PA
16602-2415
US

V. Phone/Fax

Practice location:
  • Phone: 814-949-6149
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number230064679
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number230064679
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: