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Individual

SAMUEL THAMPI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
33 WALT WHITMAN RD, STE-100, HUNTINGTON STATION, NY 11746-3640
(631) 470-2021
(631) 207-8567
Mailing address
14 BELAIR DR, OLD BETHPAGE, NY 11804-1445
(516) 382-7808
(631) 207-8567

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
220673
NY
208VP0014X
Interventional Pain Medicine Physician
Primary
220673
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02316865
NY
Enumeration date
06/15/2005
Last updated
12/12/2012
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