Healthcare Provider Details

I. General information

NPI: 1760178834
Provider Name (Legal Business Name): SOMA DEALL-WILLIAMS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 MONTAUK HWY STE 4
WEST ISLIP NY
11795-4939
US

IV. Provider business mailing address

1175 MONTAUK HWY STE 4
WEST ISLIP NY
11795-4939
US

V. Phone/Fax

Practice location:
  • Phone: 631-422-9600
  • Fax:
Mailing address:
  • Phone: 631-422-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number342526
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: