Basic Information
| Provider Information | |||||||||
| NPI: | 1972866101 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SORIA | ||||||||
| FirstName: | MARGARITA | ||||||||
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| Credential: | SPECIAL INSTRUCTOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11201 QUEENS BLVD | ||||||||
| Address2: | APT. # 24 C | ||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113755566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187939052 | ||||||||
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| Practice Location | |||||||||
| Address1: | 535 8TH AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100184305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127879700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2012 | ||||||||
| LastUpdateDate: | 06/22/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 252Y00000X | 56900 | NY | Y | Agencies | Early Intervention Provider Agency |
ID Information
| ID | Type | State | Issuer | Description | 2127879700 | 01 | NY | LOS NINOS SERVICES | OTHER |