Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 350091 | NY |
NPI | 1053454751 |
---|---|
Provider Name | Tracey Sotomayor |
First Address | Syracuse, NY 13203-1843 |
Second Address | Syracuse, NY 13203-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 18/07/2013 |