Provider Demographics
NPI:1184631509
Name:SAMADI, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:SAMADI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:625 MADISON AVE. 2ND FL.
Mailing Address - Street 2:MOUNT SINAI MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-241-8779
Mailing Address - Fax:212-308-6107
Practice Address - Street 1:625 MADISON AVE. 2ND FL.
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-241-8779
Practice Address - Fax:212-308-6107
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY208749208800000X
NY208749-1208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H72704Medicare UPIN