Healthcare Provider Details

I. General information

NPI: 1316854284
Provider Name (Legal Business Name): SAMUEL A. TAYLOR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 E 71ST ST
NEW YORK NY
10021-4871
US

IV. Provider business mailing address

PO BOX 12124
HAUPPAUGE NY
11788-0839
US

V. Phone/Fax

Practice location:
  • Phone: 203-705-0750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL A TAYLOR
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 203-705-0750