Provider Demographics
NPI:1124184544
Name:SAMARITAN MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:SAMARITAN MEDICAL SERVICES, P.C.
Other - Org Name:SAMARITAN MEDICAL SVCS. P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIANS BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HANNIGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:631-224-8533
Mailing Address - Street 1:1000 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4927
Mailing Address - Country:US
Mailing Address - Phone:631-376-4003
Mailing Address - Fax:631-224-8560
Practice Address - Street 1:1000 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4927
Practice Address - Country:US
Practice Address - Phone:631-376-4003
Practice Address - Fax:631-224-8560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty