Provider Demographics
NPI:1154303295
Name:SOSIS, MITCHEL B (MD)
Entity Type:Individual
Prefix:
First Name:MITCHEL
Middle Name:B
Last Name:SOSIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3536
Mailing Address - Country:US
Mailing Address - Phone:609-587-2020
Mailing Address - Fax:609-588-9545
Practice Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-3536
Practice Address - Country:US
Practice Address - Phone:609-587-2020
Practice Address - Fax:609-588-9545
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03649600207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
29114OtherUNIVERSITY HEALTH PLAN
6L1301OtherWELLCHOICE
NJ8663408Medicaid
001614114OtherAMERIHEALTH PPO
86616OtherFIRST HEALTH
87839OtherAMERIGROUP
930826OtherONE HEALTHPLAN
1144287OtherHORIZON NJ HEALTH
P2404351OtherOXFORD
2K0375OtherHEALTHNET
37770OtherMASTERCARE
2291261000OtherAMERIHEALTH HMO
75876OtherUNITED HEALTHCARE
2589977OtherAETNA
86616OtherFIRST HEALTH
1144287OtherHORIZON NJ HEALTH
29114OtherUNIVERSITY HEALTH PLAN