MEDICARE: TYLER SOROKA PT

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
1	225100000X	Physical Therapist	027534	NY

General Provider Information

NPI Number	:	1962614222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER SOROKA PT

Provider Business Mailing Address
First Line	:	1255 5TH AVE
Second Line	:	APT 6L
City	:	NEW YORK
State	:	NY
Zip	:	10029-3852
Country	:	US
Telephone Number	:	914-400-1500
Fax Number	:	914-478-8781

Provider Business Practice Location Address
First Line	:	139 E 57TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-2102
Country	:	US
Telephone Number	:	914-400-1500
Fax Number	:	914-478-8781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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Directions to “ TYLER SOROKA PT” Practice Location

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