Individual
DR. SAMANTHA MEGAN WYCKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2600
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(718) 920-3185
(718) 882-3185
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
306481-01
NY
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
MD480318
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
06/12/2023
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