Provider Demographics
NPI:1376258228
Name:SOMAN, REMYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:REMYA
Middle Name:
Last Name:SOMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2929
Mailing Address - Country:US
Mailing Address - Phone:516-476-1235
Mailing Address - Fax:
Practice Address - Street 1:15345 CROSS ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-2648
Practice Address - Country:US
Practice Address - Phone:929-362-3666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist