Basic Information
| Provider Information | |||||||||
| NPI: | 1588724413 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOTOLONGO | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | EDUARDO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 89 THIRD ST | ||||||||
| Address2: | |||||||||
| City: | PELHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108031432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147387347 | ||||||||
| FaxNumber: | 9149255169 | ||||||||
| Practice Location | |||||||||
| Address1: | 275 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105281524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149255326 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 194488 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.