Provider Demographics
NPI:1710966064
Name:SOTSKY, CAROL ANN O'HAGAN (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN O'HAGAN
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 1:947 LINWOOD AVE
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2939
Mailing Address - Country:US
Mailing Address - Phone:201-447-6468
Mailing Address - Fax:201-447-3189
Practice Address - Street 1:947 LINWOOD AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2939
Practice Address - Country:US
Practice Address - Phone:201-447-6468
Practice Address - Fax:201-447-3189
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52271207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ110069102OtherRAILROAD MEDICARE#
NJ1132502OtherHORIZON NJ HEALTH#
NJ1006662OtherAETNA HMO#
NJ0814709Medicaid
NJ0K3394OtherHEALTHNET#
NJ91001208500OtherAMERICHOICE#
NJBS408OtherOXFORD#
NJ81012OtherAMERIGROUP#
NJ4327081OtherAETNA PPO#
NJ25N401OtherEMPIRE BC/BS#
NJ1132502OtherHORIZON NJ HEALTH#
NJ81012OtherAMERIGROUP#