Individual
DR. SHAWN KUNJUMON SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, MS
Contact information
Practice address
1825 EASTCHESTER RD, BRONX, NY 10461-2301
(718) 904-2400
(718) 904-2827
Mailing address
102 MOUNTAIN AVE, NEW ROCHELLE, NY 10804-4722
(914) 269-8777
(888) 300-0458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
239243
NY
208M00000X
Hospitalist Physician
Primary
239243
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02811374
—
NY
Enumeration date
10/04/2006
Last updated
02/16/2023
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