Provider Demographics
NPI:1235242736
Name:SOTO, ANA BERENICE (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:BERENICE
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 VAN WYCK EXPY
Mailing Address - Street 2:JAMAICA HOSPITAL - EMERG DEPT
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2897
Mailing Address - Country:US
Mailing Address - Phone:718-206-6070
Mailing Address - Fax:718-206-6085
Practice Address - Street 1:8900 VAN WYCK EXPY
Practice Address - Street 2:JAMAICA HOSPITAL - EMERG DEPT
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2897
Practice Address - Country:US
Practice Address - Phone:718-206-6070
Practice Address - Fax:718-206-6085
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167767208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics