Samsonov, Dmitry V

Samsonov, Dmitry V is an individual health care provider with primary practice located at 19 Bradhurst Ave Ste 1400, Hawthorne NY 10532-2140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as his primary health care specialty. Samsonov, Dmitry V can be contacted via phone (914) 493-7583.

Contact Information

Primary practice address
19 Bradhurst Ave Ste 1400 Hawthorne NY 10532-2140
Phone: (914) 493-7583
Fax: (914) 594-4011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X 003556 New York
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X 269800 New York

Profile Details

NPI number 1356595862
LBN Legal business name Samsonov, Dmitry V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2008
Last updated Jul 23rd, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356595862 NPPES
New York MEDICAID 03266039

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