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Individual

MR. JACEK T SOSNOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3580 SHERIDAN DR, SUITE 150, AMHERST, NY 14226-1645
(716) 834-0100
(716) 834-1161
Mailing address
2805 N OAK ST, SUITE B, VALDOSTA, GA 31602
(229) 316-2990
(229) 259-9547

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
058647
GA
208800000X
Urology Physician
199804
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
211307866A
GA
Enumeration date
11/03/2005
Last updated
04/02/2010
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