MEDICARE: DR. AKHTAR H SAMAD M.D., PH.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	207ZP0101X	Anatomic Pathology Physician	197108	NY

General Provider Information

NPI Number	:	1750532735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKHTAR H SAMAD M.D., PH.D.

Provider Business Mailing Address
First Line	:	4 MARTINE AVE
Second Line	:	#1616
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-4016
Country	:	US
Telephone Number	:	845-494-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 MARTINE AVE
Second Line	:	#1616
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-4016
Country	:	US
Telephone Number	:	845-494-0736
Fax Number	:

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

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	10/08/2008

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