Healthcare Provider Details

I. General information

NPI: 1902959620
Provider Name (Legal Business Name): ANDREW SAMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 PARK AVE
HUNTINGTON NY
11743-2787
US

IV. Provider business mailing address

270 PARK AVE
HUNTINGTON NY
11743-2787
US

V. Phone/Fax

Practice location:
  • Phone: 631-351-2000
  • Fax:
Mailing address:
  • Phone: 631-351-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number152570
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: