Provider Demographics
NPI:1386902740
Name:SOSNOVITCH, TALIA (DPT)
Entity type:Individual
Prefix:DR
First Name:TALIA
Middle Name:
Last Name:SOSNOVITCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27600 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4439
Mailing Address - Country:US
Mailing Address - Phone:216-464-8460
Mailing Address - Fax:
Practice Address - Street 1:27600 CHAGRIN BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4439
Practice Address - Country:US
Practice Address - Phone:216-464-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT. 0134802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic