Healthcare Provider Details

I. General information

NPI: 1376244418
Provider Name (Legal Business Name): ZACHARY SOKOL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 WALNUT ST STE 620
PHILADELPHIA PA
19107-5005
US

IV. Provider business mailing address

1015 WALNUT ST STE 620
PHILADELPHIA PA
19107-5005
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6864
  • Fax: 215-955-2878
Mailing address:
  • Phone: 215-955-5638
  • Fax: 215-955-2878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT232123
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: