Gurdine Soma, B.S
Individual provider Active NPI Pharmacist · Farmingdale, NJ
NPI 1497078596 · NPPES record last updated Mar 4, 2010
Key facts
- NPI
- 1497078596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI02708300 (NJ)
- Practice address
- 11 Ethan Dr
Farmingdale, NJ 07727-3776 - Phone
- (732) 919-1210
- Fax
- (732) 919-1210
- NPI assigned
- Mar 4, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02708300 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Drugstore Inc | Current | Accepting new patients | |
| Soma Pharmacy LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02708300 | NJ | Yes |
Addresses
Primary practice location
11 Ethan Dr
Farmingdale, NJ 07727-3776
Mailing address
11 Ethan Dr
Farmingdale, NJ 07727-3776
Phone (732) 919-1210
Other names
- Miss Gurdine Andre
Other providers in Farmingdale, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.