Individual
SAMUEL BAVLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7315
(718) 869-8530
Mailing address
327 BEACH 19TH ST, DEPT. OF MEDICINE, FAR ROCKAWAY, NY 11691-4423
(718) 869-7315
(718) 869-8530
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
109310-1
NY
207RH0005X
Hypertension Specialist Physician
109310
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00887018
—
NY
Enumeration date
08/31/2006
Last updated
05/20/2013
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