Provider Demographics
NPI:1780735456
Name:FS SOMERSET, LLC
Entity type:Organization
Organization Name:FS SOMERSET, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:TAY
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:908-595-0799
Mailing Address - Street 1:150 ORLANDO DR
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2124
Mailing Address - Country:US
Mailing Address - Phone:908-595-0799
Mailing Address - Fax:908-595-0032
Practice Address - Street 1:150 ORLANDO DR
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-2124
Practice Address - Country:US
Practice Address - Phone:908-595-0799
Practice Address - Fax:908-595-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5348630001Medicare ID - Type Unspecified