Basic Information
Provider Information | |||||||||
NPI: | 1285725267 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SOMER | ||||||||
FirstName: | ROBERT | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1 FEDERAL ST STE SW200 | ||||||||
Address2: |   | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031155 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563564924 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2 COOPER PLZ | ||||||||
Address2: | 400 HADDON AVE | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031461 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8556322667 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/27/2006 | ||||||||
LastUpdateDate: | 10/29/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 10/29/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | MD-069340-L | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 25MA07566300 | NJ | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
ID | Type | State | Issuer | Description | 010005392 | 01 | NJ | AMERICHOICE | OTHER | 0826747 | 01 | NJ | CIGNA | OTHER | 2336468 | 01 | NJ | UNITED HEALTHCARE | OTHER | 60000416 | 01 | NJ | HORIZON -NJ HEALTH | OTHER | 38475 | 01 | NJ | UNIVERSITY HEALTH CARE | OTHER | 0002631 | 05 | NJ |   | MEDICAID | 2192263000 | 01 | NJ | AMERICHEALTH HMO | OTHER | P00035881 | 01 | NJ | RAILROAD MEDICARE | OTHER | 3218286 | 01 | NJ | AETNA US HEALTHCARE | OTHER | 3K5930 | 01 | NJ | HEALTHNET, INC | OTHER | P2938542 | 01 | NJ | OXFORD HEALTH PLAN | OTHER | 1503951 | 01 | NJ | AMERIHEALTH PPO PABS | OTHER |