Individual
DR. SAMSON MEBRAHTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 MONTAUK HWY, BAY SHORE, NY 11706-8403
(631) 758-4444
Mailing address
712 MAIN ST, ISLIP, NY 11751-3620
(631) 758-4444
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
177795
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01340981
—
NY
Enumeration date
02/06/2006
Last updated
01/25/2017
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