Provider Demographics
NPI:1750532735
Name:SAMAD, AKHTAR H (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:AKHTAR
Middle Name:H
Last Name:SAMAD
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARTINE AVE
Mailing Address - Street 2:#1616
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-4016
Mailing Address - Country:US
Mailing Address - Phone:845-494-0736
Mailing Address - Fax:
Practice Address - Street 1:4 MARTINE AVE
Practice Address - Street 2:#1616
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-4016
Practice Address - Country:US
Practice Address - Phone:845-494-0736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197108207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology