Provider Demographics
NPI:1174300941
Name:PATRIOT MEDICAL WOUND HEALTH PC
Entity type:Organization
Organization Name:PATRIOT MEDICAL WOUND HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-362-8400
Mailing Address - Street 1:96 LINWOOD PLZ # 142
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3701
Mailing Address - Country:US
Mailing Address - Phone:914-236-4121
Mailing Address - Fax:845-362-8474
Practice Address - Street 1:286 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3327
Practice Address - Country:US
Practice Address - Phone:914-236-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty