Individual
MR. CHARLES SOTOVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1468 MADISON AVE DEPT OF, NEW YORK, NY 10029-6508
(212) 241-7473
Mailing address
44 AUTUMN AVE, BROOKLYN, NY 11208-1512
(718) 213-3281
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
620794
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
123658
NY
Other
Enumeration date
07/16/2018
Last updated
03/26/2022
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