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1598392912

NPI Code Detail

MEDICARE: ANDREW SAMOYEDNY MD

MEDICARE: ANDREW SAMOYEDNY MD

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	2085R0204X	Vascular & Interventional Radiology Physician	MT221272	PA
2	2085R0204X	Vascular & Interventional Radiology Physician	MD478113	PA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	2085R0204X	Vascular & Interventional Radiology Physician	25MA13089800	NJ

General Provider Information

NPI Number	:	1598392912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW SAMOYEDNY MD

Provider Business Mailing Address
First Line	:	3400 SPRUCE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 SPRUCE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4238
Country	:	US
Telephone Number	:	215-316-5151
Fax Number	:

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	05/25/2026

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Directions to “ ANDREW SAMOYEDNY MD” Practice Location

Language	Start Address	Practice Location

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