Provider Demographics
NPI:1013211556
Name:SOTER, SULTANA (DPT)
Entity Type:Individual
Prefix:
First Name:SULTANA
Middle Name:
Last Name:SOTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2701
Mailing Address - Country:US
Mailing Address - Phone:718-680-5640
Mailing Address - Fax:
Practice Address - Street 1:431 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2701
Practice Address - Country:US
Practice Address - Phone:718-680-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-24
Last Update Date:2010-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist