Provider Demographics
NPI:1053378075
Name:SOSNOWIK, DAVID J (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:SOSNOWIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 AUSTIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4763
Mailing Address - Country:US
Mailing Address - Phone:718-830-9500
Mailing Address - Fax:718-793-8407
Practice Address - Street 1:7010 AUSTIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4763
Practice Address - Country:US
Practice Address - Phone:718-830-9500
Practice Address - Fax:718-793-8407
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165028207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE40744Medicare UPIN
NY24820HMedicare PIN
NY24820HMedicare ID - Type Unspecified