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General NPI Number Information
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NPI Number | 1750687836
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Entity Type | Organization
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Legal Business Name | JUAN B SOSA, MD PC
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 267 WILLIAM ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3212
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Country | US
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Telephone | 860-301-7051
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Fax |
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Provider Business Mailing Address
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Address Line | 267 WILLIAM ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3212
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RITA TROLIO
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Credential |
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Telephone | 413-732-6293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 012797
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License Number State | CT
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