Provider Demographics
NPI:1073726600
Name:DAVID B SAMADI MD PC
Entity Type:Organization
Organization Name:DAVID B SAMADI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-366-6161
Mailing Address - Street 1:303 S BROADWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5413
Mailing Address - Country:US
Mailing Address - Phone:914-366-6161
Mailing Address - Fax:914-366-6101
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:914-366-6161
Practice Address - Fax:914-366-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208749208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty