Provider Demographics
NPI:1497272561
Name:SAMUEL, MAISHA (MS ECE, MS TSWD,TEFL)
Entity Type:Individual
Prefix:MISS
First Name:MAISHA
Middle Name:
Last Name:SAMUEL
Suffix:
Gender:F
Credentials:MS ECE, MS TSWD,TEFL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 E 92ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-1244
Mailing Address - Country:US
Mailing Address - Phone:646-659-1276
Mailing Address - Fax:
Practice Address - Street 1:116 WEST 32ND STREET
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:646-659-1276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1152211171174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist