Provider Demographics
NPI:1336250927
Name:SAMARNEH, NEDAL ZAHI (MD)
Entity Type:Individual
Prefix:
First Name:NEDAL
Middle Name:ZAHI
Last Name:SAMARNEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 SOUNDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2945
Mailing Address - Country:US
Mailing Address - Phone:718-991-7330
Mailing Address - Fax:718-328-1944
Practice Address - Street 1:609 SOUNDVIEW AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2945
Practice Address - Country:US
Practice Address - Phone:718-991-7330
Practice Address - Fax:718-328-1944
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200002207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01642479Medicaid
NY1336250927OtherINDIVIDUAL NPI
NY1851499206OtherGROUP NPI
NY01642479Medicaid
NY1851499206OtherGROUP NPI