Provider Demographics
NPI:1013239789
Name:SAMUEL, FINNY K (RPH)
Entity Type:Individual
Prefix:MR
First Name:FINNY
Middle Name:K
Last Name:SAMUEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 COVENTRY AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-2016
Mailing Address - Country:US
Mailing Address - Phone:516-747-2182
Mailing Address - Fax:
Practice Address - Street 1:92 COVENTRY AVE
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-2016
Practice Address - Country:US
Practice Address - Phone:516-747-2182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist