=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922399518
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAMANTHA D'ANNUNZIO M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2011
-----------------------------------------------------
Last Update Date | 10/24/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 THEALL RD # 202
-----------------------------------------------------
City | RYE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10580-1404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-848-8777
-----------------------------------------------------
Fax | 914-848-8778
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 WESTCHESTER AVE # 715
-----------------------------------------------------
City | RYE BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10573-1354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-607-5730
-----------------------------------------------------
Fax | 914-457-1195
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 267955
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 267955
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 267955
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------