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NPI Code Detail

MEDICARE: SORIN AMBULATORY, LLC

MEDICARE: SORIN AMBULATORY, LLC
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1477378297
Entity Type Code : Organization
Provider Name (Legal Business Name) : SORIN AMBULATORY, LLC
Provider Business Mailing Address
First Line : 120 WALL ST STE 175
Second Line :
City : NEW YORK
State : NY
Zip : 10005-3904
Country : US
Telephone Number : 212-738-0900
Fax Number : 718-266-0900
Provider Business Practice Location Address
First Line : 120 WALL ST STE 175
Second Line :
City : NEW YORK
State : NY
Zip : 10005-3904
Country : US
Telephone Number : 212-738-0900
Fax Number : 718-266-0900
Authorized Official
Title or Position : PRESIDENT /OWNER
Name : JOSEPH PUMA
Credential : DO
Telephone Number : 718-266-0900
Provider Enumeration Date : 11/18/2024
Last Update Date : 11/18/2024

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Directions to “SORIN AMBULATORY, LLC ” Practice Location

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