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General NPI Number Information
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NPI Number | 1124811021
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Entity Type | Individual
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Provider Name | SAMANTHA MALAYAO BIRUNG
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Gender | Female
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 333 7TH AVE FL 18
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City | NEW YORK
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State | NY
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Zip | 10001-5086
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Country | US
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Telephone | 917-286-5313
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Fax |
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Provider Business Mailing Address
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Address Line | 2112 LURTING AVE FL 2
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City | BRONX
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State | NY
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Zip | 10461-1214
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Country | US
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Telephone | 951-705-4060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 029426
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License Number State | NY
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