Provider Demographics
NPI:1811341654
Name:SOMAN, LINCY YOHANNAN (MPT)
Entity type:Individual
Prefix:MRS
First Name:LINCY
Middle Name:YOHANNAN
Last Name:SOMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1401 MERCANTILE LN
Mailing Address - Street 2:#107
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4301
Mailing Address - Country:US
Mailing Address - Phone:301-658-6881
Mailing Address - Fax:301-322-2563
Practice Address - Street 1:1401 MERCANTILE LN
Practice Address - Street 2:#107
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4301
Practice Address - Country:US
Practice Address - Phone:301-658-6881
Practice Address - Fax:301-322-2563
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist