Healthcare Provider Details

I. General information

NPI: 1508447772
Provider Name (Legal Business Name): SAMANTHA JANE LORIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL # 1070
NEW YORK NY
10029-6504
US

IV. Provider business mailing address

150 E 42ND ST FL 5
NEW YORK NY
10017-5612
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6500
  • Fax:
Mailing address:
  • Phone: 646-605-8119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number327593
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: