Provider Demographics
NPI:1891399242
Name:SOSA, DEAN JUSTIN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:JUSTIN
Last Name:SOSA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 PHILMAR AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3925
Mailing Address - Country:US
Mailing Address - Phone:856-924-8208
Mailing Address - Fax:
Practice Address - Street 1:520 BECKETT RD STE 200
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1732
Practice Address - Country:US
Practice Address - Phone:856-467-3421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01935200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist