Organization
RUSHING WATERS MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANYKA SAM MD (OWNER)
(917) 588-4798
Entity
Organization
Contact information
Practice address
1530 BEDFORD AVE FL 2, BROOKLYN, NY 11216-4117
(917) 588-4798
Mailing address
726 UTICA AVE UNIT 30068, BROOKLYN, NY 11203-2267
(917) 588-4798
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2024
Last updated
08/23/2024
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