Provider Demographics
NPI:1972592673
Name:SOSNIAK, ALLEN M
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:M
Last Name:SOSNIAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 LIBERTY AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3511
Mailing Address - Country:US
Mailing Address - Phone:412-281-9199
Mailing Address - Fax:
Practice Address - Street 1:717 LIBERTY AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3511
Practice Address - Country:US
Practice Address - Phone:412-281-9199
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1095591Medicaid
PA0164580001Medicare ID - Type Unspecified