Individual
LISA RENEE SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-5437
Mailing address
4003 EDGE WATER CT, VILLA RICA, GA 30180-7089
(919) 885-2006
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
252940
NC
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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