Healthcare Provider Details

I. General information

NPI: 1366360190
Provider Name (Legal Business Name): SOMVANSHI MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 RHODES DR
NEW HYDE PARK NY
11040-3528
US

IV. Provider business mailing address

2417 JERICHO TPKE STE 177
NEW HYDE PARK NY
11040-4710
US

V. Phone/Fax

Practice location:
  • Phone: 646-370-8712
  • Fax:
Mailing address:
  • Phone: 646-370-8712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SAURABH SOMVANSHI
Title or Position: EXECUTIVE OFFICAIL
Credential:
Phone: 718-564-0806