MEDICARE: DR. EDWARD A SOMMA M.D.

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	207R00000X	Internal Medicine Physician	25MA05188900	NJ

General Provider Information

NPI Number	:	1316954563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD A SOMMA M.D.

Provider Business Mailing Address
First Line	:	115 NORTH AVE
Second Line	:
City	:	HILLSIDE
State	:	NJ
Zip	:	07205-3113
Country	:	US
Telephone Number	:	908-354-7070
Fax Number	:	908-354-9300

Provider Business Practice Location Address
First Line	:	115 NORTH AVE
Second Line	:
City	:	HILLSIDE
State	:	NJ
Zip	:	07205-3113
Country	:	US
Telephone Number	:	908-354-7070
Fax Number	:	908-354-9300

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	05/29/2008

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