Provider Demographics
NPI:1013232180
Name:SOMMO, CAROLYN
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:SOMMO
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 1:57 KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4737
Mailing Address - Country:US
Mailing Address - Phone:518-862-1247
Mailing Address - Fax:518-862-0100
Practice Address - Street 1:57 KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4737
Practice Address - Country:US
Practice Address - Phone:518-862-1247
Practice Address - Fax:518-862-0100
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist