Provider Demographics
NPI:1679715080
Name:CICERO SOSA, PAOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAOLA
Middle Name:
Last Name:CICERO SOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 AMITY ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6004
Mailing Address - Country:US
Mailing Address - Phone:929-455-2500
Mailing Address - Fax:929-455-2550
Practice Address - Street 1:97 AMITY ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6004
Practice Address - Country:US
Practice Address - Phone:929-455-2500
Practice Address - Fax:929-455-2550
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003424-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine