Healthcare Provider Details

I. General information

NPI: 1801725718
Provider Name (Legal Business Name): JUAN CARLOS SOTO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JC SOTO

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 ELM ST
YONKERS NY
10701-6427
US

IV. Provider business mailing address

227 ELM ST
YONKERS NY
10701-6427
US

V. Phone/Fax

Practice location:
  • Phone: 914-261-7867
  • Fax:
Mailing address:
  • Phone: 914-261-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number124871
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: