Provider Demographics
NPI:1225774672
Name:SOTO OPTICAL LLC
Entity Type:Organization
Organization Name:SOTO OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ENEIDA
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:860-550-4561
Mailing Address - Street 1:35B S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06088-1740
Mailing Address - Country:US
Mailing Address - Phone:860-550-4561
Mailing Address - Fax:860-407-3772
Practice Address - Street 1:35B S MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-1740
Practice Address - Country:US
Practice Address - Phone:860-550-4561
Practice Address - Fax:860-407-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier