Individual provider Active NPI

Rajenie Somra

  • Clinical Social Worker
  • Baldwin, NY
National Provider Identifier
1215506365
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110089 Issued in NY
Practice address
2277 Grand Ave
Baldwin, NY 11510-3148
Phone
(516) 455-2114
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110089 NY Primary

Addresses

Primary practice location

2277 Grand Ave
Baldwin, NY 11510-3148

Mailing address

308 Magnolia Blvd
Long Beach, NY 11561-3308
Phone (516) 455-2114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110089NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1215506365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 MAGNOLIA BLVD",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613308",
            "telephone_number": "516-455-2114",
            "fax_number": "516-377-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103148",
            "telephone_number": "516-455-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMRA",
        "first_name": "RAJENIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "110089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.