Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25MA07387500 | NJ |
Y | 208600000X | Surgeon | 25MA07387500 | NJ |
N | 2082S0105X | Plastic Hand Surgeon | 25MA07387500 | NJ |
NPI | 1003875063 |
---|---|
Provider Name | Dr. Norberto Luke Soto |
First Address | Englewood, NJ 07631-3574 |
Second Address | Englewood, NJ 07631-3574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 18/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8973709 | (05) | NJ |
H62616 | (02) | NJ |