MEDICARE: NANCY SOMIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	R023583-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000505114002	OTHER	NY	HEALTH NOW

General Provider Information

NPI Number	:	1275527822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY SOMIT

Provider Business Mailing Address
First Line	:	63 MARINER ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-2029
Country	:	US
Telephone Number	:	716-881-4065
Fax Number	:	716-881-4066

Provider Business Practice Location Address
First Line	:	434 DELAWARE AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14202-1515
Country	:	US
Telephone Number	:	716-881-4065
Fax Number	:	716-881-4066

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	07/08/2007

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