Provider Demographics
NPI:1366682445
Name:SELIM, SAMY (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMY
Middle Name:
Last Name:SELIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:732-861-4139
Mailing Address - Fax:
Practice Address - Street 1:300 COMMUNITY DRIVE
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030
Practice Address - Country:US
Practice Address - Phone:516-562-2338
Practice Address - Fax:516-562-2087
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42272207R00000X
NY271369207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology