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General NPI Number Information
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NPI Number | 1437010220
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Entity Type | Organization
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Legal Business Name | SEASIDE EAR NOSE AND THROAT MEDICAL
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 6818 3RD AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-5803
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Country | US
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Telephone | 917-363-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 6818 3RD AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-5803
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Country | US
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Telephone | 917-363-6877
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RUWAA SAMARRAI
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Credential | MD
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Telephone | 917-363-6877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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