Provider Demographics
NPI:1568457653
Name:SOMNAY, KAUMUDI (MD)
Entity Type:Individual
Prefix:DR
First Name:KAUMUDI
Middle Name:
Last Name:SOMNAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:WOODMERE POST OFFICE
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-0338
Mailing Address - Country:US
Mailing Address - Phone:718-321-0670
Mailing Address - Fax:718-321-0099
Practice Address - Street 1:5514 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5058
Practice Address - Country:US
Practice Address - Phone:718-321-0670
Practice Address - Fax:718-321-0099
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197464-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02519386Medicaid
NY02519386Medicaid
NY4V2711Medicare ID - Type Unspecified