Provider Demographics
NPI:1013642495
Name:SOSA, HECTOR MANUEL JR (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:MANUEL
Last Name:SOSA
Suffix:JR
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W 77TH ST APT 12A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6783
Mailing Address - Country:US
Mailing Address - Phone:646-662-1478
Mailing Address - Fax:
Practice Address - Street 1:334 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-8205
Practice Address - Country:US
Practice Address - Phone:646-505-5716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018303225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist