Provider Demographics
NPI:1336700467
Name:SOMA POTENTIAL LLC
Entity Type:Organization
Organization Name:SOMA POTENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRCTOR OF OERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAAM
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:732-382-2211
Mailing Address - Street 1:20 MERCURY AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2512
Mailing Address - Country:US
Mailing Address - Phone:732-382-2211
Mailing Address - Fax:
Practice Address - Street 1:20 MERCURY AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-2512
Practice Address - Country:US
Practice Address - Phone:732-382-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty