| Doctor Name: | MR. JAMES SORRENTINO |
| NPI Number: | 1053376269 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW-R |
| License Number: | 077198-1 |
| Business Practice Address: | 110 Ho Plaza Cornell University, Gannett Health Services Ithaca, NY - 148533101 |
| Business Phone Number: | 6072555208 |
| Business Fax Number: | |
| Mailing Address: | 595 Nelson Rd, ITHACA |
| State: | NY |
| Postal Code: | 148509437 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2006 |
| NPI Last Update Date: | 06/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 077198-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |