Provider Demographics
NPI:1366073058
Name:SOSA, MARIA ELENA (AUD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:SOSA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WASHINGTON AVE STE 106-107
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3067
Mailing Address - Country:US
Mailing Address - Phone:888-362-3277
Mailing Address - Fax:
Practice Address - Street 1:111 WASHINGTON AVE STE 106-107
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-3067
Practice Address - Country:US
Practice Address - Phone:888-362-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00103100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist