Provider Demographics
NPI:1710548565
Name:SAMB, ABDOULAYE
Entity Type:Individual
Prefix:
First Name:ABDOULAYE
Middle Name:
Last Name:SAMB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 113TH ST APT 6G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3324
Mailing Address - Country:US
Mailing Address - Phone:646-257-8899
Mailing Address - Fax:
Practice Address - Street 1:764 E 176TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4606
Practice Address - Country:US
Practice Address - Phone:718-542-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)