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General NPI Number Information
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NPI Number | 1609976216
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Entity Type | Individual
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Provider Name | LLOYD GORDON SOMAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 343 W 58TH ST SUITE #8
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City | NEW YORK
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State | NY
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Zip | 10019-1108
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Country | US
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Telephone | 212-757-1515
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Fax | 212-757-3286
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Provider Business Mailing Address
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Address Line | 343 W 58TH ST SUITE #8
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City | NEW YORK
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State | NY
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Zip | 10019-1108
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Country | US
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Telephone | 212-757-1515
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Fax | 212-757-3286
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 037431
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 006450
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License Number State | CT
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