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General NPI Number Information
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NPI Number | 1871374140
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Entity Type | Individual
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Provider Name | ALI SOHRABY DDS
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Gender | Male
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 761 RIVER AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5200
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Country | US
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Telephone | 732-364-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 44 MERKER DR
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City | EDISON
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State | NJ
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Zip | 08837-2717
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Country | US
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Telephone | 479-871-4758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DI02994900
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License Number State | NJ
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