MEDICARE: SAMIR SODHA MD

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
1	2086S0105X	Surgery of the Hand (Surgery) Physician	232360	NY
2	207X00000X	Orthopaedic Surgery Physician	232360	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407856990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIR SODHA MD

Provider Business Mailing Address
First Line	:	155 CRYSTAL RUN RD
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10941-4028
Country	:	US
Telephone Number	:	845-703-6999
Fax Number	:	845-703-6297

Provider Business Practice Location Address
First Line	:	305 W GRAND AVE
Second Line	:
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1813
Country	:	US
Telephone Number	:	800-321-9999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	04/02/2019

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Directions to “ SAMIR SODHA MD” Practice Location

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