MEDICARE: BEATRIZ SOTELO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	297041	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	297041	OTHER	NY	NY LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417954231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ SOTELO MD

Provider Business Mailing Address
First Line	:	2360 AMSTERDAM AVE APT 3C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-7363
Country	:	US
Telephone Number	:	352-552-6483
Fax Number	:

Provider Business Practice Location Address
First Line	:	2265 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035
Country	:	US
Telephone Number	:	212-289-6650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/25/2019

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