Healthcare Provider Details

I. General information

NPI: 1295982742
Provider Name (Legal Business Name): EOS MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 STONELEIGH AVE
CARMEL NY
10512-3997
US

IV. Provider business mailing address

15 N WINTER PARK DR
HOPEWELL JUNCTION NY
12533-6963
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-5711
  • Fax: 845-278-5549
Mailing address:
  • Phone: 845-216-4666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number249854
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL ANTHONY SAMA
Title or Position: PRESIDENT / CEO
Credential: MD
Phone: 845-216-4666