Healthcare Provider Details

I. General information

NPI: 1962348458
Provider Name (Legal Business Name): SUNIL SAMNANI MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVENUE
BOSTON MA
02215
US

IV. Provider business mailing address

160 VINTON ROAD
ANCASTER ONTARIO
L9K0G7
CA

V. Phone/Fax

Practice location:
  • Phone: 617-667-8427
  • Fax: 617-667-8098
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: