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Individual

DR. RISA CHERYL SAMUELS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
61-17 220TH ST, OAKLAND GARDENS, NY 11364-2244
(718) 225-3050
(718) 225-5609
Mailing address
61-17 220TH ST, OAKLAND GARDENS, NY 11364-2244
(718) 225-3050
(718) 225-5609

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
040378
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01180501
NY
Enumeration date
03/23/2006
Last updated
07/08/2007
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