Individual
ETHAN SAMUEL WINER BEN-SOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 DAKOTA DR STE 205, NEW HYDE PARK, NY 11042-1136
(516) 622-6020
(516) 622-6021
Mailing address
1 DAKOTA DR STE 205, NEW HYDE PARK, NY 11042-1136
(516) 622-6020
(516) 622-6021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
183765
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183765
LICENSE
NY
Enumeration date
08/11/2005
Last updated
06/08/2020
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