Provider Demographics
NPI:1538319488
Name:GORELICK, SOSY S (MS)
Entity Type:Individual
Prefix:MRS
First Name:SOSY
Middle Name:S
Last Name:GORELICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 YESHIVA LANE,
Mailing Address - Street 2:P.O.BOX 301
Mailing Address - City:FALLSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12733
Mailing Address - Country:US
Mailing Address - Phone:845-693-4175
Mailing Address - Fax:845-693-4175
Practice Address - Street 1:7 YESHIVA LANE,
Practice Address - Street 2:7
Practice Address - City:FALLSBURG
Practice Address - State:NY
Practice Address - Zip Code:12733
Practice Address - Country:US
Practice Address - Phone:845-693-4175
Practice Address - Fax:845-693-4175
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor