Provider Demographics
NPI:1326010646
Name:SAMA, JALIN (MD)
Entity Type:Individual
Prefix:
First Name:JALIN
Middle Name:
Last Name:SAMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PROSPECT AVE
Mailing Address - Street 2:ANESTHESIOLOGIST CARE, P.C.
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2907
Mailing Address - Country:US
Mailing Address - Phone:518-828-8307
Mailing Address - Fax:518-828-8528
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:ANESTHESIOLOGIST CARE, P.C.
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-8307
Practice Address - Fax:518-828-8528
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY231983207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY231983-8BOtherWORKER'S COMPENSATION
NY02104658Medicaid
NY02104658Medicaid
NY231983-8BOtherWORKER'S COMPENSATION