Provider Demographics
NPI:1700840204
Name:SOHMER, KENETTE KAY (MD)
Entity Type:Individual
Prefix:MS
First Name:KENETTE
Middle Name:KAY
Last Name:SOHMER
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 1:3461 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-6021
Mailing Address - Country:US
Mailing Address - Phone:908-526-5424
Mailing Address - Fax:
Practice Address - Street 1:3461 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-6021
Practice Address - Country:US
Practice Address - Phone:908-526-5424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02569600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1907301Medicaid
140817B72Medicare ID - Type Unspecified
NJ1907301Medicaid