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Individual

DR. RYAN RICHARD SORG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
213 W LACEY RD, FORKED RIVER, NJ 08731-3507
(609) 693-7800
(609) 693-8004
Mailing address
213 W LACEY RD, FORKED RIVER, NJ 08731-3507
(609) 693-7800
(609) 693-8004

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
270A00297100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0325830001
DME MEDICARE
NJ
05
2180006
NJ
Enumeration date
07/19/2006
Last updated
12/15/2008
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