Provider Demographics
NPI:1982187241
Name:SOSIK, KIMBERLY C (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:C
Last Name:SOSIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GREEN MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2586
Mailing Address - Country:US
Mailing Address - Phone:484-885-6133
Mailing Address - Fax:
Practice Address - Street 1:2221 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1418
Practice Address - Country:US
Practice Address - Phone:916-734-3229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant