Basic Information
Provider Information
NPI: 1003804493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOSIS
FirstName: ARTHUR
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1259 S CEDAR CREST BLVD
Address2: SUITE 100
City: ALLENTOWN
State: PA
PostalCode: 181036206
CountryCode: US
TelephoneNumber: 6104374134
FaxNumber: 6107700993
Practice Location
Address1: 1259 S CEDAR CREST BLVD
Address2: SUITE 100
City: ALLENTOWN
State: PA
PostalCode: 181036206
CountryCode: US
TelephoneNumber: 6104374134
FaxNumber: 6107700993
Other Information
ProviderEnumerationDate: 10/10/2005
LastUpdateDate: 08/30/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000XMD012271EPAY Allopathic & Osteopathic PhysiciansDermatology 
207NS0135XMD012271EPAN Allopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology

ID Information
IDTypeStateIssuerDescription
17242401PAHIGHMARKOTHER
0234300001PACAPITAL BLUE CROSSOTHER


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