Individual
MS. THAYDENE C SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3000
Mailing address
713 DECATUR ST, UNIONDALE, NY 11553-2217
(516) 903-8508
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
014160
NY
Other
Enumeration date
08/18/2010
Last updated
12/21/2022
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