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Individual

MRS. LUCY SOURIAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
247 THIRD AVE, NEW YORK, NY 10010
(212) 529-1709
(212) 529-5205
Mailing address
247 THIRD AVE, NEW YORK, NY 10010
(212) 529-1709
(212) 529-5205

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
141804
NY
207RH0000X
Hematology (Internal Medicine) Physician
Primary
141804
NY
207RH0003X
Hematology & Oncology Physician
141804
NY
207RH0003X
Hematology & Oncology Physician
MA66626
NJ
207RX0202X
Medical Oncology Physician
141804
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00901175
NY
Enumeration date
02/21/2006
Last updated
11/22/2021
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