1821033168 NPI number — DR. CARL ANDREW SORANNO MD FAAP

Table of content: DR. CARL ANDREW SORANNO MD FAAP (NPI 1821033168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821033168 NPI number — DR. CARL ANDREW SORANNO MD FAAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SORANNO
Provider First Name:
CARL
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD FAAP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821033168
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
53 HARRINGTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINDENHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11757-3397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-266-2600
Provider Business Mailing Address Fax Number:
631-226-3027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
53 HARRINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINDENHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11757-3397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-266-2600
Provider Business Practice Location Address Fax Number:
631-226-3027
Provider Enumeration Date:
06/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  1709091 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010170909NY01 . This is a "BILLING ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 48468 . This is a "AETNA GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: CS078 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: OP207P . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 170909A85 . This is a "HEALTHFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200409 . This is a "CO MED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2601228 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: SF0000957 . This is a "SELECT PRO WJ JONES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01073743 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4211133 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 875354 . This is a "PPO POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: AG01509 . This is a "MDNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000068083 . This is a "HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0532077 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0577486002 . This is a "CIGNA PAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10677 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20H461 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 49099005 . This is a "ATLANTIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: OCO669 . This is a "PHYSICANS HEALTH PHS" identifier . This identifiers is of the category "OTHER".




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