Provider Demographics
NPI:1821047010
Name:SAMADI, DILARA E (M)
Entity Type:Individual
Prefix:DR
First Name:DILARA
Middle Name:E
Last Name:SAMADI
Suffix:
Gender:F
Credentials:M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1150
Practice Address - Fax:716-630-1265
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188431-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161000580OtherNORTH AMERICAN PREFERRED
NY00010155701OtherUNIVERA
NY161000580OtherEMPIRE
NY04042600164OtherFIDELIS
NY161000580OtherAETNA
NY161000580OtherNOVA
NY000523670007OtherHEALTH NOW
NY01567959Medicaid
NY000523670007OtherHEALTH NOW
NYG01457Medicare UPIN