Provider Demographics
NPI:1093134652
Name:PYSER, SAMANTHA A (RD, CDN, CDE)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:A
Last Name:PYSER
Suffix:
Gender:F
Credentials:RD, CDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LINCOLN HOSPITAL-234 E. 149 STREET
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-579-4657
Mailing Address - Fax:718-579-4744
Practice Address - Street 1:LINCOLN HOSPITAL-234 E. 149 STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-4657
Practice Address - Fax:718-579-4744
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006938133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered