Provider Demographics
NPI:1194499632
Name:SOTOMAYOR, ALEJANDRA B
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:B
Last Name:SOTOMAYOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10502 WESTLAKE DR APT 104
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1010
Mailing Address - Country:US
Mailing Address - Phone:240-561-9152
Mailing Address - Fax:
Practice Address - Street 1:10502 WESTLAKE DR APT 104
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1010
Practice Address - Country:US
Practice Address - Phone:240-561-9152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCNA20212374376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide