Individual
SAMUEL UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1727 AMSTERDAM AVE FL 3, NEW YORK, NY 10031-4611
(212) 694-9200
(212) 694-4619
Mailing address
1727 AMSTERDAM AVE FL 3, NEW YORK, NY 10031-4611
(212) 694-9200
(212) 694-4619
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4158
NY
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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