Provider Demographics
NPI:1447973425
Name:SOSA, VARINIA (NP)
Entity type:Individual
Prefix:
First Name:VARINIA
Middle Name:
Last Name:SOSA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14210 ROOSEVELT AVE APT 220
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6026
Mailing Address - Country:US
Mailing Address - Phone:646-915-4071
Mailing Address - Fax:
Practice Address - Street 1:4008 FORLEY ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4698
Practice Address - Country:US
Practice Address - Phone:718-446-0270
Practice Address - Fax:718-446-5939
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily