Provider Demographics
NPI:1245871912
Name:SUBEDI, SOM NATH
Entity type:Individual
Prefix:
First Name:SOM
Middle Name:NATH
Last Name:SUBEDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 FARMINGTON PL
Mailing Address - Street 2:
Mailing Address - City:LANDISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17538-1917
Mailing Address - Country:US
Mailing Address - Phone:603-264-7022
Mailing Address - Fax:
Practice Address - Street 1:96 FARMINGTON PL
Practice Address - Street 2:
Practice Address - City:LANDISVILLE
Practice Address - State:PA
Practice Address - Zip Code:17538-1917
Practice Address - Country:US
Practice Address - Phone:603-264-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care