Provider Demographics
NPI:1225441744
Name:MAHR, SAMANTHA KAYNE
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KAYNE
Last Name:MAHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 57TH ST STE 501
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10107-0500
Mailing Address - Country:US
Mailing Address - Phone:212-582-1566
Mailing Address - Fax:212-586-1272
Practice Address - Street 1:250 W 57TH ST STE 501
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0500
Practice Address - Country:US
Practice Address - Phone:212-582-1566
Practice Address - Fax:212-586-1272
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator