Individual
LARRY SORRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4011
Mailing address
PO BOX 2283, MOULTRIE, GA 31776-2283
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
300197
NY
Other
Enumeration date
04/04/2015
Last updated
09/29/2021
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