Healthcare Provider Details

I. General information

NPI: 1285550434
Provider Name (Legal Business Name): BRIAN R SOTOMAYOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4366 BUFFALO RD
NORTH CHILI NY
14514-1206
US

IV. Provider business mailing address

4366 BUFFALO RD
NORTH CHILI NY
14514-1206
US

V. Phone/Fax

Practice location:
  • Phone: 585-594-5689
  • Fax:
Mailing address:
  • Phone: 585-594-5689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number07397101
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: