Provider Demographics
NPI:1417039066
Name:SOMMER, WARREN
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:
Last Name:SOMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1223
Mailing Address - Country:US
Mailing Address - Phone:973-467-1859
Mailing Address - Fax:
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:732-390-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA21040207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1852108Medicaid
NJ199908A01Medicare PIN
NJ1852108Medicaid