Provider Demographics
NPI:1093097610
Name:SOSA, CHRISTINE JANE (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JANE
Last Name:SOSA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1508
Mailing Address - Country:US
Mailing Address - Phone:973-907-2775
Mailing Address - Fax:
Practice Address - Street 1:409 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2707
Practice Address - Country:US
Practice Address - Phone:201-337-2349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI27428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist