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General NPI Number Information
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NPI Number | 1720904295
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Entity Type | Individual
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Provider Name | SAMUEL MALEBRANCHE
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Gender | Male
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Dates
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Enumeration Date | 06/27/2026
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Last Update Date | 06/27/2026
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Provider Practice Location Address
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Address Line | 401 FRANKLIN AVE STE 301
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City | GARDEN CITY
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State | NY
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Zip | 11530-5942
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Country | US
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Telephone | 516-740-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 7133A 260TH ST
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City | GLEN OAKS
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State | NY
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Zip | 11004-1120
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Country | US
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Telephone | 718-974-0902
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 131276
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License Number State | NY
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