Provider Demographics
NPI:1417693771
Name:SOSA, JUAN PABLO (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:PABLO
Last Name:SOSA
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 1:234 EAST 149THE STREET
Mailing Address - Street 2:LINCOLN HOSPITAL, DEPARTMENT OF PEDIATRICS, SUITE 4-20
Mailing Address - City:BRONK
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-5030
Mailing Address - Fax:718-579-4700
Practice Address - Street 1:234 EAST 149THE STREET OF PEDIATRICS, SUITE 4-20
Practice Address - Street 2:LINCOLN HOSPITAL, DEPARTMENT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5030
Practice Address - Fax:718-579-4700
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2023-02-06
Deactivation Date:2022-12-21
Deactivation Code:
Reactivation Date:2023-02-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program