Provider Demographics
NPI:1275754137
Name:AKL, SAMUEL I (PT)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:AKL
Suffix:I
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3761
Mailing Address - Country:US
Mailing Address - Phone:718-382-8881
Mailing Address - Fax:718-382-8880
Practice Address - Street 1:215 AVENUE T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3761
Practice Address - Country:US
Practice Address - Phone:718-382-8881
Practice Address - Fax:718-382-8880
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027913174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist