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General NPI Number Information
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NPI Number | 1972708857
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Entity Type | Organization
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Legal Business Name | SUSAN F. SORDONI, MD PC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 250 PIERCE ST SUITE 115
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City | KINGSTON
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State | PA
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Zip | 18704-5149
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Country | US
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Telephone | 570-714-2999
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Fax | 570-714-2903
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Provider Business Mailing Address
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Address Line | PO BOX 1164
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City | KINGSTON
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State | PA
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Zip | 18704-0164
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Country | US
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Telephone | 570-714-2999
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Fax | 570-714-2903
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Authorized Official
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Title or Position | FAMILY PRACTICE PHYSICIAN
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Name | MS. SUSAN F. SORDONI
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Credential | MD
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Telephone | 570-714-2999
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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 | MD072550L
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License Number State | PA
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