Individual
DR. STANLEY SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2925 WEST 19TH STREET, BROOKLYN, NY 11224
(718) 616-6029
Mailing address
12851 HEACOCK STREET, MORENO VALLEY, CA 92553
(214) 404-0181
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
278507
NY
2084P0800X
Psychiatry Physician
278507
NY
2084P0802X
Addiction Psychiatry Physician
Primary
278507
NY
Other
Enumeration date
08/18/2013
Last updated
11/02/2021
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