Provider Demographics
NPI:1124419239
Name:LIM, SAMUEL W (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:W
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7559 263RD ST
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1150
Mailing Address - Country:US
Mailing Address - Phone:718-470-8005
Mailing Address - Fax:718-962-7717
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-8300
Practice Address - Fax:718-470-3629
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2019-05-31
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Provider Licenses
StateLicense IDTaxonomies
NY2960332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry