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: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 BRONX RIVER RD APT 402
YONKERS NY
10704-1745
US

IV. Provider business mailing address

697 BRONX RIVER RD APT 402
YONKERS NY
10704-1745
US

V. Phone/Fax

Practice location:
  • Phone: 914-562-5548
  • Fax:
Mailing address:
  • Phone: 914-562-5548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: