Provider Demographics
NPI:1275621351
Name:SOSA, NEYSA M (RPH)
Entity Type:Individual
Prefix:
First Name:NEYSA
Middle Name:M
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:PO BOX 213
Mailing Address - Street 2:CAROLINA PUEBLO STATION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986-0213
Mailing Address - Country:US
Mailing Address - Phone:787-603-9389
Mailing Address - Fax:
Practice Address - Street 1:390 CARR 853 KM 0.3
Practice Address - Street 2:BARRIO TRUJILLO BAJO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-257-2420
Practice Address - Fax:787-752-3908
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist