Provider Demographics
NPI:1336963867
Name:SORTO, CECILIA
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:SORTO
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 WISCONSIN AVE STE 1209
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4301
Mailing Address - Country:US
Mailing Address - Phone:301-366-1450
Mailing Address - Fax:301-560-4936
Practice Address - Street 1:5530 WISCONSIN AVE STE 1209
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4301
Practice Address - Country:US
Practice Address - Phone:301-366-1450
Practice Address - Fax:301-560-4936
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician