Provider Demographics
NPI:1083733877
Name:SOTO, ANA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:MARIA
Other - Last Name:COMPANY SOTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:65 GORDON ROAD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468
Mailing Address - Country:US
Mailing Address - Phone:617-965-4492
Mailing Address - Fax:617-965-4492
Practice Address - Street 1:10 LANGLEY ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459
Practice Address - Country:US
Practice Address - Phone:617-527-4055
Practice Address - Fax:617-527-2571
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA449782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
873029Medicare UPIN