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NPI Code Detail

MEDICARE: DR. NEIL SOROKIN PSYCHOLOGIST

MEDICARE: DR. NEIL SOROKIN PSYCHOLOGIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist1773CO

General Provider Information

NPI Number : 1083308126
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NEIL SOROKIN PSYCHOLOGIST
Provider Business Mailing Address
First Line : 9364 TEDDY LN STE 204
Second Line :
City : LONE TREE
State : CO
Zip : 80124-2873
Country : US
Telephone Number : 720-675-7222
Fax Number :
Provider Business Practice Location Address
First Line : 9364 TEDDY LN STE 204
Second Line :
City : LONE TREE
State : CO
Zip : 80124-2873
Country : US
Telephone Number : 720-675-7222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2023
Last Update Date : 06/02/2023

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