Provider Demographics
NPI:1093465031
Name:SOTAYO, BARIAT
Entity Type:Individual
Prefix:MRS
First Name:BARIAT
Middle Name:
Last Name:SOTAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 DUCKETTS LN APT 304
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6893
Mailing Address - Country:US
Mailing Address - Phone:240-264-7828
Mailing Address - Fax:
Practice Address - Street 1:2100 GENERALS HWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-6723
Practice Address - Country:US
Practice Address - Phone:410-224-7669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist