Individual
GLENN SORRENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
139 FULTON ST RM 700, NEW YORK, NY 10038-2533
(212) 406-0134
Mailing address
25 HARRISON CT, WEST PATERSON, NJ 07424-3411
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X005012
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GS0X0F8210
BLUE CROSS BLUE SHIELD
NY
Enumeration date
07/07/2006
Last updated
05/12/2008
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