Healthcare Provider Details

I. General information

NPI: 1417690488
Provider Name (Legal Business Name): SAMANTHA SALUDADES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 PARKSIDE AVE STE 2
BROOKLYN NY
11226-2990
US

IV. Provider business mailing address

672 PARKSIDE AVE STE 2
BROOKLYN NY
11226-2990
US

V. Phone/Fax

Practice location:
  • Phone: 718-246-5700
  • Fax: 718-889-7132
Mailing address:
  • Phone: 718-246-5700
  • Fax: 718-889-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number337401-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: