Provider Demographics
NPI:1962615781
Name:SORIN, SUZANNAH (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:SUZANNAH
Middle Name:
Last Name:SORIN
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 ESSEX ST.
Mailing Address - Street 2:SUITE 403- UROLOGY
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:551-223-5289
Mailing Address - Fax:551-996-8221
Practice Address - Street 1:360 ESSEX ST.
Practice Address - Street 2:SUITE 403- UROLOGY
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:551-996-2506
Practice Address - Fax:551-996-8221
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010772363AS0400X
NJ25MP00147000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical