Individual
LLERAS A SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8815 GERMANTOWN AVE, PHILADELPHIA, PA 19118-2722
(215) 707-5864
(215) 707-6867
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-5864
(215) 707-6864
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD050516L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015133600006
—
PA
Enumeration date
10/12/2005
Last updated
04/09/2018
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