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NPI Code Detail

MEDICARE: JOHN SAMMIS D.O.

MEDICARE: JOHN SAMMIS D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician302221NY

General Provider Information

NPI Number : 1366896227
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN SAMMIS D.O.
Provider Business Mailing Address
First Line : 325 MAIN ST
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-1790
Country : US
Telephone Number : 631-230-2030
Fax Number : 631-423-2306
Provider Business Practice Location Address
First Line : 325 MAIN ST
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-1790
Country : US
Telephone Number : 631-230-2030
Fax Number : 613-423-2306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2016
Last Update Date : 11/24/2021

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