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General NPI Number Information
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NPI Number | 1629350418
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Entity Type | Individual
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Provider Name | SAMUEL ASFAHA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 630 W 168TH ST NEWYORK-PRESBYTERIAN/COLUMBIA UNIVERSITY
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 212-851-4580
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 SAINT NICHOLAS AVE RM 9259TH
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City | NEW YORK
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State | NY
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Zip | 10032-3802
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Country | US
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Telephone | 212-851-4580
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 003932
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License Number State | NY
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