Provider Demographics
NPI:1952485278
Name:FRANKEL, SAMUEL JUDAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JUDAH
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 HAZEL PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1109
Mailing Address - Country:US
Mailing Address - Phone:516-295-0774
Mailing Address - Fax:
Practice Address - Street 1:1011 HAZEL PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1109
Practice Address - Country:US
Practice Address - Phone:516-295-0774
Practice Address - Fax:516-295-0774
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006274103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV22781Medicare UPIN