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Individual

THERESA ANN SOROKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
199 BROAD ST, SUITE 2A, BLOOMFIELD, NJ 07003
(973) 748-4583
(973) 748-3243
Mailing address
PO BOX 308, CEDAR GROVE, NJ 07009
(973) 748-4583
(973) 748-3243

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA05040300
NJ
207RI0200X
Infectious Disease Physician
Primary
25MA05040300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2101700
NJ
Enumeration date
02/09/2006
Last updated
06/22/2010
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