Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 25MA09523100 | NJ |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 274811 | NY |
NPI | 1639475635 |
---|---|
Provider Name | Andrew M Somberg |
First Address | Nanuet, NY 10954-5238 |
Second Address | West Nyack, NY 10994-2226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2011 |
Last Update Date | 26/02/2016 |