Provider Demographics
NPI:1427561554
Name:SAMLAL, ROSHNIE (SPECIAL ED TEACHER)
Entity Type:Individual
Prefix:MS
First Name:ROSHNIE
Middle Name:
Last Name:SAMLAL
Suffix:
Gender:F
Credentials:SPECIAL ED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 BROOKRIDGE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-1856
Mailing Address - Country:US
Mailing Address - Phone:845-633-6755
Mailing Address - Fax:
Practice Address - Street 1:21 BURD ST
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3205
Practice Address - Country:US
Practice Address - Phone:845-353-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-11
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1770244208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics