Organization
NY COMPREHENSIVE MEDICAL WELLNESS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SORACE MD (MANAGING EMPLOYEE)
(830) 331-9900
Entity
Organization
Contact information
Practice address
329 E 149TH ST, BRONX, NY 10451-5625
(718) 585-5500
(718) 585-5502
Mailing address
2 S END AVE APT TH8, NEW YORK, NY 10280-1089
(830) 331-9900
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
288165
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115644
NYSED ID
NY
Enumeration date
11/02/2017
Last updated
11/02/2017
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