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NPI Code Detail

MEDICARE: SOMOS HEALTHCARE PROVIDERS, INC

MEDICARE: SOMOS HEALTHCARE PROVIDERS, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1578391074
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOMOS HEALTHCARE PROVIDERS, INC
Provider Business Mailing Address
First Line : 2910 EXTERIOR ST FL 1
Second Line :
City : BRONX
State : NY
Zip : 10463-7104
Country : US
Telephone Number : 212-740-8294
Fax Number :
Provider Business Practice Location Address
First Line : 2910 EXTERIOR ST FL 1
Second Line :
City : BRONX
State : NY
Zip : 10463-7104
Country : US
Telephone Number : 212-740-8294
Fax Number :
Authorized Official
Title or Position : CHIEF OF STAFF
Name : STEPHANIE DULUC
Credential :
Telephone Number : 347-736-6122
Provider Enumeration Date : 07/25/2024
Last Update Date : 07/25/2024

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Directions to “SOMOS HEALTHCARE PROVIDERS, INC ” Practice Location

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