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General NPI Number Information
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NPI Number | 1760941868
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Entity Type | Individual
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Provider Name | SAMUEL WARREN ROSS
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1111 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-1617
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Country | US
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Telephone | 516-663-4600
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Fax | 516-663-3008
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Provider Business Mailing Address
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Address Line | 700 HICKSVILLE RD STE 205
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City | BETHPAGE
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State | NY
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Zip | 11714-3472
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Country | US
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Telephone |
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 317200
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License Number State | NY
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