Individual
TARSHA SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 PELHAM PKWY S, BRONX, NY 10461-1138
(718) 918-5000
Mailing address
1400 PELHAM PKWY S, BRONX, NY 10461-1138
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1720226582
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720226582
—
NY
Enumeration date
01/30/2009
Last updated
12/26/2014
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