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General NPI Number Information
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NPI Number | 1376806208
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Entity Type | Individual
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Provider Name | MATTHEW SOSNOWSKY
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Gender | Male
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 148 N 3RD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1733
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Country | US
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Telephone | 610-217-7955
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40333 615 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-0333
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Country | US
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Telephone | 610-217-7955
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 18136
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50080383
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License Number State | DC
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