Individual
SAMUEL MASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
622 WEST 168TH ST, VC4, NEW YORK, NY 10032
(212) 342-3233
(212) 342-4733
Mailing address
622 WEST 168TH ST, VC 4, NEW YORK, NY 10032
(212) 342-3200
(212) 342-4733
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
294447
NY
208000000X
Pediatrics Physician
OT016663
PA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
294447
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22-2540851
—
PA
Enumeration date
06/08/2015
Last updated
12/05/2024
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