Provider Demographics
NPI:1801963491
Name:SOMERSET SURGICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:SOMERSET SURGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-249-9010
Mailing Address - Street 1:475 E 72ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4458
Mailing Address - Country:US
Mailing Address - Phone:212-249-9010
Mailing Address - Fax:212-249-0713
Practice Address - Street 1:475 E 72ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4458
Practice Address - Country:US
Practice Address - Phone:212-249-9010
Practice Address - Fax:212-249-0713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093532174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWO5411Medicare ID - Type Unspecified