Provider Demographics
NPI:1205851011
Name:DANIEL SAMADI, M.D. PC
Entity type:Organization
Organization Name:DANIEL SAMADI, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-996-1505
Mailing Address - Street 1:130 W PLEASANT AVE
Mailing Address - Street 2:# 304
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1335
Mailing Address - Country:US
Mailing Address - Phone:201-996-1505
Mailing Address - Fax:201-996-1605
Practice Address - Street 1:10 FOREST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5242
Practice Address - Country:US
Practice Address - Phone:201-996-1505
Practice Address - Fax:201-996-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty