Provider Demographics
NPI:1740572593
Name:SOTO, MERCEDES (RN)
Entity Type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 S ARIZONA RD # RSS
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-3318
Mailing Address - Country:US
Mailing Address - Phone:516-281-5054
Mailing Address - Fax:
Practice Address - Street 1:37 S ARIZONA RD # RSS
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-3318
Practice Address - Country:US
Practice Address - Phone:516-281-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 580421163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency