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General NPI Number Information
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NPI Number | 1568755460
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Entity Type | Individual
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Provider Name | SAMEH ELGUIZAOUI MD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 159 E 74TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-3235
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Country | US
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Telephone | 212-737-3301
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Fax | 212-734-0407
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Provider Business Mailing Address
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Address Line | 159 E 74TH ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10021-3309
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Country | US
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Telephone | 212-737-3301
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 283141
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License Number State | NY
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