Healthcare Provider Details

I. General information

NPI: 1184659807
Provider Name (Legal Business Name): RICHARD L SOHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 GRANT AVE SUITE 201
PHILADELPHIA PA
19115-4378
US

IV. Provider business mailing address

2 AMARYLLIS LN
NEWTOWN PA
18940-1246
US

V. Phone/Fax

Practice location:
  • Phone: 215-969-3944
  • Fax: 215-969-3886
Mailing address:
  • Phone: 215-968-1862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD423936
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: