Healthcare Provider Details

I. General information

NPI: 1972592673
Provider Name (Legal Business Name): MR. ALLEN M SOSNIAK
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 LIBERTY AVE SUITE 410
PITTSBURGH PA
15222-3511
US

IV. Provider business mailing address

717 LIBERTY AVE SUITE 410
PITTSBURGH PA
15222-3511
US

V. Phone/Fax

Practice location:
  • Phone: 412-281-9199
  • Fax:
Mailing address:
  • Phone: 412-281-9199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: