Provider Demographics
NPI:1659146496
Name:SOSA, KARINA STEPHANIE
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:STEPHANIE
Last Name:SOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 HALSEY ST APT 9CC
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1462
Mailing Address - Country:US
Mailing Address - Phone:347-781-6140
Mailing Address - Fax:
Practice Address - Street 1:250 W 54TH ST STE 804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5558
Practice Address - Country:US
Practice Address - Phone:212-884-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029848225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist