MEDICARE: DR. SAMANTHA MADHOSINGH PSYD

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	103TC0700X	Clinical Psychologist	0810003364	VA
2	103TC0700X	Clinical Psychologist	PSY1000235	DC

General Provider Information

NPI Number	:	1922301423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA MADHOSINGH PSYD

Provider Business Mailing Address
First Line	:	1934 OLD GALLOWS RD
Second Line	:	350
City	:	VIENNA
State	:	VA
Zip	:	22182-4042
Country	:	US
Telephone Number	:	703-717-5060
Fax Number	:	703-652-8326

Provider Business Practice Location Address
First Line	:	1934 OLD GALLOWS RD
Second Line	:	350
City	:	VIENNA
State	:	VA
Zip	:	22182-4042
Country	:	US
Telephone Number	:	703-717-5060
Fax Number	:	703-652-8326

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

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	12/06/2010

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