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General NPI Number Information
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NPI Number | 1831765668
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Entity Type | Organization
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Legal Business Name | DR MARK SORRENTINO
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 403 MAIN ST STE 510
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City | BUFFALO
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State | NY
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Zip | 14203-2107
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Country | US
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Telephone | 716-852-7262
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Fax | 716-852-7267
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Provider Business Mailing Address
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Address Line | 403 MAIN ST STE 510
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City | BUFFALO
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State | NY
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Zip | 14203-2107
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Country | US
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Telephone | 716-852-7262
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DENISE SORRENTINO
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Credential |
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Telephone | 716-536-1179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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