MEDICARE: DR. SHELBY KEVIN SAMUEL M.D.

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
1	207RG0100X	Gastroenterology Physician	176352	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114947157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELBY KEVIN SAMUEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 391
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10602-0391
Country	:	US
Telephone Number	:	718-498-7888
Fax Number	:	718-604-7890

Provider Business Practice Location Address
First Line	:	200 BROOKLYN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-1908
Country	:	US
Telephone Number	:	718-498-7888
Fax Number	:	718-604-7890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	02/10/2012

Similar Medicare Providers

1073835641 — BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC
Practice Location Address:

200 BROOKLYN AVE
BROOKLYN, NY
11213-1908

Practice Phone: 718-498-7888
Practice Fax: 718-604-7890

1942686951 — BROOKLYN AVENUE MEDICAL PLLC
Practice Location Address:

200 BROOKLYN AVE
BROOKLYN, NY
11213-1908

Practice Phone: 718-498-7888
Practice Fax: 718-604-7890

1780230508 — CHERYL WILLIAMS
Practice Location Address:

210 BROOKLYN AVE
BROOKLYN, NY
11213-1908

Practice Phone: 718-877-7466
Practice Fax:

1265462931 — DR. ANDZHELIKA KAGZANOVA D.O.
Practice Location Address:

1908 AVENUE K
BROOKLYN, NY
11230-4904

Practice Phone: 718-859-6786
Practice Fax: 866-481-4658

1154336709 — RX CHOICE PHARMACY INC
Practice Location Address:

1908 AVENUE U
BROOKLYN, NY
11229-3906

Practice Phone: 718-368-1190
Practice Fax: 718-368-0665

1780770982 — ANDREW PAUL WARSHAW DMD
Practice Location Address:

245 FIFTH AVE
BROOKLYN, NY
11215-1908

Practice Phone: 718-789-5700
Practice Fax: 718-789-8968

Directions to “ DR. SHELBY KEVIN SAMUEL M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.