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General NPI Number Information
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NPI Number | 1831200088
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Entity Type | Organization
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Legal Business Name | SAMSON PACHIKARA MD PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/05/2010
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Provider Practice Location Address
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Address Line | 123 GENESEE ST
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2323
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Country | US
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Telephone | 315-797-2314
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Fax | 315-797-0850
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Provider Business Mailing Address
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Address Line | 123 GENESEE ST
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2323
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Country | US
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Telephone | 315-797-2314
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Fax | 315-797-0850
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Authorized Official
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Title or Position | CEO
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Name | SAMSON A PACHIKARA
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Credential | MD
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Telephone | 315-797-2314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 221758
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 203801
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License Number State | NY
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