Provider Demographics
NPI:1053579953
Name:SOMEKH, NIR N (MD)
Entity type:Individual
Prefix:DR
First Name:NIR
Middle Name:N
Last Name:SOMEKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:833 NORTHERN BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5315
Mailing Address - Country:US
Mailing Address - Phone:516-829-6660
Mailing Address - Fax:516-829-9641
Practice Address - Street 1:1000 NORTHERN BLVD STE 360
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5312
Practice Address - Country:US
Practice Address - Phone:516-829-6660
Practice Address - Fax:516-829-9641
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248622207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400074146Medicare PIN