Joo H Sohn, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

112275 Issued in NY

Practice address

285 Sills Road
BLDG 1 Suite a
East Patchogue, NY 11772-4875

Phone

(631) 475-3102

Fax

(631) 475-3489

NPI assigned

Oct 26, 2006

Last updated

Jan 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1649355785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BLDG 1 SUITE A",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-475-3102",
            "fax_number": "631-475-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS ROAD",
            "address_2": "BLDG 1 SUITE A",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724875",
            "telephone_number": "631-475-3102",
            "fax_number": "631-475-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHN",
        "first_name": "JOO",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "112275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00621274",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL IDENTIFICATION #",
            "identifier": "113063286",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.