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General NPI Number Information
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NPI Number | 1376822114
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Entity Type | Individual
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Provider Name | ABDUL JAWWAD SAMDANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-396-1980
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 72098
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City | CLEVELAND
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State | OH
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Zip | 44192-0002
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Country | US
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Telephone | 513-557-3330
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Fax | 513-557-3214
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 301112
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License Number State | NY
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