Provider Demographics
NPI:1184624827
Name:BEKAR, SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:BEKAR
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 1:359 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3937
Mailing Address - Country:US
Mailing Address - Phone:718-787-1017
Mailing Address - Fax:718-787-1032
Practice Address - Street 1:359 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3937
Practice Address - Country:US
Practice Address - Phone:718-787-1017
Practice Address - Fax:718-787-1032
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225007208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01704223Medicaid
NYH72713Medicare UPIN
NY01704223Medicaid