Provider Demographics
NPI:1679815922
Name:SOSIN, BETH L (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:L
Last Name:SOSIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:LYNN
Other - Last Name:WOLEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:973-763-4334
Mailing Address - Fax:973-763-4355
Practice Address - Street 1:SOUTH ORANGE OB/GYN & INFERTILITY GROUP
Practice Address - Street 2:106 VALLEY STREET, RAMP ENTRANCE
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079
Practice Address - Country:US
Practice Address - Phone:973-763-4334
Practice Address - Fax:973-763-4355
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0075650207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD067187800Medicaid
MD067187800Medicaid
MD293558ZAEMedicare PIN