Healthcare Provider Details

I. General information

NPI: 1841125077
Provider Name (Legal Business Name): RYAN JAMES SOTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OXFORD VLY STE 100
LANGHORNE PA
19047-3310
US

IV. Provider business mailing address

631 KNOWLES AVE
SOUTHAMPTON PA
18966-4101
US

V. Phone/Fax

Practice location:
  • Phone: 215-278-6881
  • Fax:
Mailing address:
  • Phone: 267-981-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number32288112
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: