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General NPI Number Information
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NPI Number | 1013642495
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Entity Type | Individual
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Provider Name | HECTOR MANUEL SOSA JR. MASSAGE THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 334 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10023-8205
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Country | US
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Telephone | 646-505-5716
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Fax |
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Provider Business Mailing Address
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Address Line | 227 W 77TH ST APT 12A
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City | NEW YORK
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State | NY
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Zip | 10024-6783
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Country | US
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Telephone | 646-662-1478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 018303
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License Number State | NY
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