Provider Demographics
NPI:1932322625
Name:SOSNICK, VINCENT GEORGE
Entity Type:Individual
Prefix:PROF
First Name:VINCENT
Middle Name:GEORGE
Last Name:SOSNICK
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:VINCENT
Other - Middle Name:GEORGE
Other - Last Name:SOSNICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:1210 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1620 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2101
Practice Address - Country:US
Practice Address - Phone:724-224-2166
Practice Address - Fax:724-224-3732
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE002274L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant