Healthcare Provider Details

I. General information

NPI: 1467315457
Provider Name (Legal Business Name): SOMAFORM HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SALEM ST STE 204
LYNNFIELD MA
01940-0029
US

IV. Provider business mailing address

50 SALEM ST STE 204 BUILDING A. SUITE 204
LYNNFIELD MA
01940-0029
US

V. Phone/Fax

Practice location:
  • Phone: 617-678-7473
  • Fax:
Mailing address:
  • Phone: 617-678-7473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. SOIMISE VERDIEU
Title or Position: FOUNDER/CEO
Credential: PHD, FNP
Phone: 617-678-7473