Physician Compare National (NPI:1982767463)

HEALTHCARE PROVIDER: EDWARD SODARO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1982767463
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830365972
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111220000642
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SODARO
	Individual professional last name
Provider First Name	EDWARD
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1973
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC PSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	137 BROADWAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE E
	Group Practice or individual's line 2 address
City	AMITYVILLE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117012731
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6316910807
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y