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Individual

DR. LINDA BUSCH SOMACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
3930 RICHMOND AVE, SUITE 104, STATEN ISLAND, NY 10312-5100
(718) 605-6383
(718) 605-6384
Mailing address
26 VINCENT AVE, STATEN ISLAND, NY 10306-2137
(718) 605-6383
(718) 605-6384

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
012048
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01605632
NY
01
092198
VALUE OPTIONS ID
NY
01
241097
MHN PROVIDER ID
NY
01
6153853
UNITED HEALTHCARE ID
NY
01
6885393
GHI PROVIDER ID
NY
01
P2356070
OXFORD ID
NY
Enumeration date
07/29/2006
Last updated
07/09/2007
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