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Individual
MRS. LISA A SORRENTINO
Active
Individual
MRS. LISA A SORRENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011299
NY
363A00000X
Physician Assistant
011299-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027798901
UNIVERA
NY
01
—
00027798902
UNIVERA
NY
01
—
000528916001
BCBS
NY
01
—
000528916002
BCBS
NY
05
—
02839196
—
NY
01
—
070209000070
FIDELIS
NY
01
—
197646BJ
PREFERRED CARE
NY
01
—
9514041
INDEPENDENT HEALTH
NY
Enumeration date
09/25/2006
Last updated
08/05/2022
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