Basic Information
| Provider Information | |||||||||
| NPI: | 1477749190 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOHI | ||||||||
| FirstName: | SUKHPREIT | ||||||||
| MiddleName: | KAUR | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 219 REECEVILLE RD | ||||||||
| Address2: | FL 2 | ||||||||
| City: | COATESVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193201546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103838000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2600 E 18TH ST | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820015511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076333025 | ||||||||
| FaxNumber: | 3076337202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2007 | ||||||||
| LastUpdateDate: | 01/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 116016226 | VA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 8654A | WY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 1477749190 | 05 | WY | MEDICAID |