Provider Demographics
NPI:1619074135
Name:SOTSKY, MINDY J (MD)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:J
Last Name:SOTSKY
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 1:401 COLUMBUS AVENUE
Mailing Address - Street 2:SUITE 2013
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1080
Mailing Address - Country:US
Mailing Address - Phone:203-838-4000
Mailing Address - Fax:203-845-9535
Practice Address - Street 1:401 COLUMBUS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1325
Practice Address - Country:US
Practice Address - Phone:914-269-9622
Practice Address - Fax:914-495-3775
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY161833207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004187466Medicaid
CTF74602Medicare UPIN
CT110007990Medicare ID - Type Unspecified