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NPI Code Detail

MEDICARE: RONEN SAMUELS OTR/L

MEDICARE:   RONEN  SAMUELS  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist018981NY

General Provider Information

NPI Number : 1013319177
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONEN SAMUELS OTR/L
Provider Business Mailing Address
First Line : 3053 HENRY HUDSON PKWY
Second Line :
City : BRONX
State : NY
Zip : 10463-4700
Country : US
Telephone Number : 917-574-8341
Fax Number :
Provider Business Practice Location Address
First Line : 3053 HENRY HUDSON PKWY
Second Line :
City : BRONX
State : NY
Zip : 10463-4700
Country : US
Telephone Number : 917-574-8341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2014
Last Update Date : 09/20/2014

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Directions to “ RONEN SAMUELS OTR/L” Practice Location

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