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NPI Code Detail

MEDICARE: MR. SOHAIL SOOKRAM PHYSICIAN ASSISTANT

MEDICARE: MR. SOHAIL SOOKRAM PHYSICIAN ASSISTANT
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
1363A00000XPhysician AssistantNY

General Provider Information

NPI Number : 1154254704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SOHAIL SOOKRAM PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 9560 115TH ST
Second Line :
City : SOUTH RICHMOND HILL
State : NY
Zip : 11419-1126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 E 68TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10065-4870
Country : US
Telephone Number : 212-746-5454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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