Provider Demographics
NPI:1871655696
Name:RAI, SAMANTHA (MD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:RAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MAIN ST
Mailing Address - Street 2:OPEN DOOR FAMILY MEDICAL CENTERS, INC.
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4702
Mailing Address - Country:US
Mailing Address - Phone:914-941-1263
Mailing Address - Fax:914-941-0993
Practice Address - Street 1:30 W MAIN ST
Practice Address - Street 2:OPEN DOOR FAMILY MEDICAL CENTERS, INC.
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1910
Practice Address - Country:US
Practice Address - Phone:914-666-3272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY224508-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03288222Medicaid