Healthcare Provider Details

I. General information

NPI: 1033053475
Provider Name (Legal Business Name): CN SBHC SONIA SOTOMAYOR MS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 RIGGS RD
ADELPHI MD
20783-1630
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 301-749-4722
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PHILLICIA NELSON
Title or Position: VP, FINANCIAL PAYOR RELATIONS
Credential:
Phone: 301-572-6281