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NPI Code Detail

MEDICARE: GABRIEL SOMARRIBA PSYD

MEDICARE: GABRIEL SOMARRIBA PSYD
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
1103T00000XPsychologist7450OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518375476
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL SOMARRIBA PSYD
Provider Business Mailing Address
First Line : PO BOX 391057
Second Line :
City : SOLON
State : OH
Zip : 44139-8057
Country : US
Telephone Number : 440-668-8564
Fax Number : 877-844-4869
Provider Business Practice Location Address
First Line : 6575 ASHTON LN
Second Line :
City : SOLON
State : OH
Zip : 44139-3213
Country : US
Telephone Number : 440-668-8564
Fax Number : 877-844-4869
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2014
Last Update Date : 01/19/2017

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