MEDICARE: DR. SAM STANFORD PARSIA 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	215480	NY
2	207RP1001X	Pulmonary Disease Physician	D0079882	NY
3	207RP1001X	Pulmonary Disease Physician	D0079882	MD

General Provider Information

NPI Number	:	1528286275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAM STANFORD PARSIA MD

Provider Business Mailing Address
First Line	:	67 SKILLMAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-2208
Country	:	US
Telephone Number	:	212-263-6479
Fax Number	:

Provider Business Practice Location Address
First Line	:	3210 POWDER MILL RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-1029
Country	:	US
Telephone Number	:	301-937-3939
Fax Number	:

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/22/2024

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