Organization Active NPI

Delaware Valley Plastic Surgery, P.a.

  • Plastic and Reconstructive Surgery Physician
  • Cherry Hill, NJ
National Provider Identifier
1184760183
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
25MA07541400 Issued in NJ
Legal business name
DELAWARE VALLEY PLASTIC SURGERY, P.A.
Practice address
1734 Marlton Pike East
Cherry Hill, NJ 08003
Phone
(856) 797-0202
Fax
(856) 751-7700
NPI assigned
Jan 29, 2007
Last updated
Jan 23, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
DELAWARE VALLEY PLASTIC SURGERY, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Evan S. Sorokin, M.D.NPI 1619960325
Title
Owner
Phone
(856) 797-0202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 25MA07541400 NJ Primary

Addresses

Primary practice location

1734 Marlton Pike East
Cherry Hill, NJ 08003

Mailing address

1734 Marlton Pike East
Cherry Hill, NJ 08003
Phone (856) 797-0202

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2056628Delaware Valley Plastic Surgery, PA1734 Marlton Pike East, Cherry Hill, NJ 08003Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory
Part of
Delaware Valley Plastic

Locations

100 Brick Rd
Ste 215
Marlton, NJ 08053
Phone (856) 334-5810

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1184760183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 MARLTON PIKE EAST",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08003",
            "telephone_number": "856-797-0202",
            "fax_number": "856-751-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 MARLTON PIKE EAST",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08003",
            "telephone_number": "856-797-0202",
            "fax_number": "856-751-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE VALLEY PLASTIC SURGERY, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELAWARE VALLEY PLASTIC SURGERY, P.A.",
        "enumeration_date": "2007-01-29",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "SOROKIN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-797-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA07541400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.