Healthcare Provider Details

I. General information

NPI: 1447333588
Provider Name (Legal Business Name): JUAN L. SOTOMAYOR, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/06/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5229 WITZ DRIVE
NORTH SYRACUSE NY
13212
US

IV. Provider business mailing address

5229 WITZ DRIVE
NORTH SYRACUSE NY
13212
US

V. Phone/Fax

Practice location:
  • Phone: 315-701-9500
  • Fax:
Mailing address:
  • Phone: 315-701-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: JUAN L SOTOMAYOR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 315-701-9500