1003120890 NPI number — SOTOMAYOR HOSPITAL SERVICES PSC

Table of content: MISS SHIVANI A KHOSLA M.S. BCBA (NPI 1356977870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003120890 NPI number — SOTOMAYOR HOSPITAL SERVICES PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOTOMAYOR HOSPITAL SERVICES PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003120890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
AVE. DR SUSONI
Provider Second Line Business Mailing Address:
#284 B
Provider Business Mailing Address City Name:
HATILLO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-898-3387
Provider Business Mailing Address Fax Number:
787-898-3387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE. DR SUSONI
Provider Second Line Business Practice Location Address:
#284 B
Provider Business Practice Location Address City Name:
HATILLO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-898-3387
Provider Business Practice Location Address Fax Number:
787-898-3387
Provider Enumeration Date:
08/04/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOTOMAYOR
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
FELIPE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-356-3543

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  13493 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)