Provider Demographics
NPI:1578775102
Name:SOMAINI, MICHELLE L
Entity Type:Individual
Prefix:MR
First Name:MICHELLE
Middle Name:L
Last Name:SOMAINI
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 1:30 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-2129
Mailing Address - Country:US
Mailing Address - Phone:802-272-5461
Mailing Address - Fax:
Practice Address - Street 1:29 MAIN ST
Practice Address - Street 2:RITE AID
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-8292
Practice Address - Country:US
Practice Address - Phone:802-223-4787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033-0002669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist