Provider Demographics
NPI:1902126329
Name:SOKOLOSKY, WILLIAM CHARLES
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:SOKOLOSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02808-0204
Mailing Address - Country:US
Mailing Address - Phone:401-322-7320
Mailing Address - Fax:
Practice Address - Street 1:823 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE VALLEY
Practice Address - State:RI
Practice Address - Zip Code:02832-1920
Practice Address - Country:US
Practice Address - Phone:401-539-2461
Practice Address - Fax:401-539-2676
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00234363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant