Individual
VIJAYA L SOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-3415
Mailing address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ML20008271
WA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
261539
NY
Other
Enumeration date
08/31/2006
Last updated
08/15/2011
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