Provider Demographics
NPI:1972117851
Name:QUIJANO-SOTO, CYNTHIA M
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:QUIJANO-SOTO
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 1:931 SILVER LAKE SCOTCHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1120
Mailing Address - Country:US
Mailing Address - Phone:646-685-9894
Mailing Address - Fax:
Practice Address - Street 1:815 BLOOMING GROVE TPKE STE 601
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8138
Practice Address - Country:US
Practice Address - Phone:845-527-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031797-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist