Organization
SAMUEL BAVLI, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL BAVLI MD (OWNER)
(718) 869-7315
Entity
Organization
Contact information
Practice address
327 BEACH 19TH ST, DEPARTMENT OF MEDICINE, FAR ROCKAWAY, NY 11691-4423
(718) 869-7315
Mailing address
327 BEACH 19TH ST, DEPARTMENT OF MEDICINE, FAR ROCKAWAY, NY 11691-4423
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
109310-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00887018
—
NY
01
—
06060
GHI NUMBER
NY
Enumeration date
06/18/2009
Last updated
06/18/2009
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