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General NPI Number Information
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NPI Number | 1679745764
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Entity Type | Organization
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Legal Business Name | DHANRAJ J. SOOGREE M.D. P.C.
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 144 W 4TH ST
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City | OSWEGO
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State | NY
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Zip | 13126-2504
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Country | US
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Telephone | 315-342-2521
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Fax | 315-342-4277
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Provider Business Mailing Address
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Address Line | 144 W 4TH ST
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City | OSWEGO
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State | NY
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Zip | 13126-2504
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Country | US
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Telephone | 315-342-2521
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Fax | 315-342-4277
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Authorized Official
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Title or Position | OWNER
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Name | DHANRAJ JATTAN SOOGREE
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Credential | M.D.
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Telephone | 315-342-2521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 210443
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License Number State | NY
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