Provider Demographics
NPI:1285306175
Name:SOSA, MONICA SCHIRLY
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:SCHIRLY
Last Name:SOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 DORSEY ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2904
Mailing Address - Country:US
Mailing Address - Phone:347-451-4374
Mailing Address - Fax:
Practice Address - Street 1:2430 DORSEY ST FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2904
Practice Address - Country:US
Practice Address - Phone:347-451-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor