Olga Bienvenida Soto-Moise, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

208310 Issued in NY

Practice address

151 Knollcroft Rd
Lyons Vamc BLDG 143 BP PTSD Unit
Lyons, NJ 07939-5001

Phone

(908) 647-0180

Fax

(908) 604-5258

NPI assigned

Sep 3, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rutgers Health-RWJ Scleroderma Program

  • Psychologist
  • Piscataway, NJ
  • NPI 1700968187
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1750483210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WISHNOW WAY",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071481",
            "telephone_number": "908-252-0553",
            "fax_number": "908-604-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "address_2": "LYONS VAMC BLDG 143 BP PTSD UNIT",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO-MOISE",
        "first_name": "OLGA",
        "middle_name": "BIENVENIDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA06606600",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": "25MA06606600",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "208310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loveleen Sidhu, MD
• Christopher Small, PHARMD
• Irmhild Wrede Smith, RN
• Jennifer Keenan Smith, PH.D.
• Melanie Snider, CTRS
• Lauren St Hill
• Melissa Rose Stellitano, DMD
• Susan K Strahs, RD,CDE
• Bradley David Sussner, PH.D.
• Angela Tardanico, O.D.

• Psychiatry Physician in Lyons, NJ
• Providers in Lyons, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.