Individual
MAHENDRA JADUNAUTH SAMAROO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8544 150TH ST, JAMAICA, NY 11435-2826
(718) 657-5785
Mailing address
8544 150TH ST, JAMAICA, NY 11435-2826
(718) 657-5785
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
014926
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PV2321U
—
NY
Enumeration date
08/24/2011
Last updated
08/24/2011
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