| Somidil Medical Pc | |
|
15 Twin Ponds Ln Syosset NY 11791-1004 | |
| (845) 634-6500 | |
| (845) 634-9424 |
| Full Name | Somidil Medical Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 15 Twin Ponds Ln, Syosset, New York |
| Authorized Official Name and Position | Marie Farrell (DIRECTOR CODING/COMPLIANCE) |
| Authorized Official Contact | 8456346500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Somidil Medical Pc 17 Squadron Blvd Suite 400 New City NY 10956-5214 Ph: (845) 634-6500 | Somidil Medical Pc 15 Twin Ponds Ln Syosset NY 11791-1004 Ph: (845) 634-6500 |
| NPI Number | 1215103486 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 05/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215103486 | NPI | - | NPPES |
| 01877614 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 211961 (New York) | Primary |
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