Basic Information
| Provider Information | |||||||||
| NPI: | 1194710368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOSSNER | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | ESTHER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 NEW SCOTLAND AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182624942 | ||||||||
| FaxNumber: | 5182625291 | ||||||||
| Practice Location | |||||||||
| Address1: | 16 NEW SCOTLAND AVE | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182624942 | ||||||||
| FaxNumber: | 5182625291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2005 | ||||||||
| LastUpdateDate: | 12/09/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 234682 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 02621456 | 05 | NY | MEDICAID |