MEDICARE: SAMUEL BARST 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	207L00000X	Anesthesiology Physician	153721	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	:	1922004308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL BARST M.D.

Provider Business Mailing Address
First Line	:	19 BRADHURST AVE STE 3100N
Second Line	:
City	:	HAWTHORNE
State	:	NY
Zip	:	10532-2140
Country	:	US
Telephone Number	:	914-909-9018
Fax Number	:	914-909-9028

Provider Business Practice Location Address
First Line	:	100 WOODS RD
Second Line	:
City	:	VALHALLA
State	:	NY
Zip	:	10595-1530
Country	:	US
Telephone Number	:	914-493-7000
Fax Number	:	914-493-7927

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	12/16/2020

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