Provider Demographics
NPI:1982697975
Name:KOSZER, SAMUEL E (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:E
Last Name:KOSZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21 FOX STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4723
Mailing Address - Country:US
Mailing Address - Phone:845-452-9750
Mailing Address - Fax:845-452-9751
Practice Address - Street 1:21 FOX STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4723
Practice Address - Country:US
Practice Address - Phone:845-452-9750
Practice Address - Fax:845-452-9751
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1902172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03728567Medicaid
NY93328OtherGHI HMO
NY000115077212OtherUNITED HEALTH CARE
NY4661659OtherAETNA
NY6875056OtherCIGNA
NY518436633OtherMULTIPLAN
NY148202OtherWELLCARE
NY5C5034OtherHEALTHNET
NY618N5-1OtherEMPIRE BLUE CROSS/BLUE SH
NYP797841OtherOXFORD
NY000405248005OtherBS OF NE
NY01527595Medicaid
NY10032555OtherCDPHP
NY3098997OtherGHI PPO
NY792527OtherMVP
NY618N5-1OtherEMPIRE BLUE CROSS/BLUE SH
NY5C5034OtherHEALTHNET
A400096415Medicare PIN