Provider Demographics
NPI:1174121115
Name:SOMERS, SAMANTHA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SOMERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 BAUM BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3763
Mailing Address - Country:US
Mailing Address - Phone:412-661-0400
Mailing Address - Fax:
Practice Address - Street 1:5770 BAUM BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3763
Practice Address - Country:US
Practice Address - Phone:412-661-0400
Practice Address - Fax:412-661-1803
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046424225100000X
PAPT030451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY046424OtherTHE UNIVERSITY OF THE STATE OF NEW YORK
PAPT030451OtherPENNSYLVANIA DEPARTMENT OF STATE