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General NPI Number Information
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NPI Number | 1437161262
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Entity Type | Individual
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Provider Name | SAMEER K MISRA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19602 HILLSIDE AVE
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City | HOLLIS
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State | NY
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Zip | 11423-2125
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Country | US
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Telephone | 718-776-2061
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Fax | 718-479-7012
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Provider Business Mailing Address
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Address Line | 19602 HILLSIDE AVE
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City | HOLLIS
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State | NY
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Zip | 11423-2125
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Country | US
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Telephone | 718-776-2061
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Fax | 718-479-7012
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 196689
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License Number State | NY
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