Healthcare Provider Details

I. General information

NPI: 1891311023
Provider Name (Legal Business Name): CHRISTOPHER SAMY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 WALBERT AVE STE 102
ALLENTOWN PA
18104-5504
US

IV. Provider business mailing address

3151 WALBERT AVE STE 102
ALLENTOWN PA
18104-5504
US

V. Phone/Fax

Practice location:
  • Phone: 610-530-8413
  • Fax: 908-847-7096
Mailing address:
  • Phone: 610-530-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD482043
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: