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General NPI Number Information
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NPI Number | 1538803200
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Entity Type | Organization
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Legal Business Name | STEFAN T. SAMUELSON MD PC
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 49 W 24TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10010-3570
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Country | US
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Telephone | 212-993-8573
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Fax |
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Provider Business Mailing Address
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Address Line | 49 W 24TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10010-3570
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Country | US
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Telephone | 212-594-1600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEFAN SAMUELSON
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Credential | MD
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Telephone | 212-594-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine 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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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