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General NPI Number Information
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NPI Number | 1629127378
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Entity Type | Individual
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Provider Name | SUSAN W. SOMERSON NP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 4900 FRANKFORD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19124-2618
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Country | US
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Telephone | 215-612-4963
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Fax | 215-807-8235
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Provider Business Mailing Address
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Address Line | 307 S EVERGREEN AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-2739
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Country | US
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Telephone | 856-686-4300
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Fax | 215-807-8235
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | VP003429B
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License Number State | PA
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