Provider Demographics
NPI:1194708248
Name:SORRENTINO, SANDY JR (MD, PHD)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:SORRENTINO
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 LONG POND RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4117
Mailing Address - Country:US
Mailing Address - Phone:585-368-6500
Mailing Address - Fax:585-368-6501
Practice Address - Street 1:1570 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4119
Practice Address - Country:US
Practice Address - Phone:585-227-7254
Practice Address - Fax:585-227-8086
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine