Healthcare Provider Details

I. General information

NPI: 1811202526
Provider Name (Legal Business Name): JOICE SAMUEL MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4334A WHITE PLAINS RD
BRONX NY
10466-3098
US

IV. Provider business mailing address

4334A WHITE PLAINS RD
BRONX NY
10466-3098
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number242185
License Number StateNY

VIII. Authorized Official

Name: JOICE SAMUEL
Title or Position: MD
Credential:
Phone: 562-753-1308