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Individual

CHARLENE SURIE SOROKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1455 E 14TH ST, BROOKLYN, NY 11230-6609
(718) 336-3459
Mailing address
1455 E 14TH ST, BROOKLYN, NY 11230-6609

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1775107
NY

Other

Enumeration date
06/14/2012
Last updated
06/14/2012
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