Healthcare Provider Details

I. General information

NPI: 1285783597
Provider Name (Legal Business Name): SOTOMAYOR MEDICAL PRACTICE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 CENTRE AVE
READING PA
19601-1458
US

IV. Provider business mailing address

1220 CENTRE AVE
READING PA
19601-1458
US

V. Phone/Fax

Practice location:
  • Phone: 610-898-1200
  • Fax: 610-898-7600
Mailing address:
  • Phone: 610-898-1200
  • Fax: 610-898-7600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberMD032776E
License Number StatePA

VIII. Authorized Official

Name: DR. MATILDE RODRIGUEZ-SOTOMAYOR
Title or Position: OWNER
Credential: M.D.
Phone: 610-898-1200