Provider Demographics
NPI:1972889509
Name:BABU, SOMY SUSAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SOMY
Middle Name:SUSAN
Last Name:BABU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TECHNOLOGY CENTER DR STE 600
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-4749
Mailing Address - Country:US
Mailing Address - Phone:781-566-5066
Mailing Address - Fax:
Practice Address - Street 1:100 TECHNOLOGY CENTER DR STE 600
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4749
Practice Address - Country:US
Practice Address - Phone:781-566-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19282183500000X
VA0202208109183500000X
NYI056571-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist