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General NPI Number Information
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NPI Number | 1013123702
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Entity Type | Organization
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Legal Business Name | JOSE M SOTO-PERELLO, MD CORPORATION
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 516 51ST ST
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-5553
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Country | US
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Telephone | 201-864-4897
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Fax | 201-864-4871
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Provider Business Mailing Address
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Address Line | 516 51ST ST
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-5553
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Country | US
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Telephone | 201-864-4897
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Fax | 201-864-4871
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE M SOTO-PERELLO
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Credential | MD
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Telephone | 201-864-4897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MA07018100
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License Number State | NJ
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