Provider Demographics
NPI:1487279725
Name:AKIFA SAMDANI, MD PC
Entity type:Organization
Organization Name:AKIFA SAMDANI, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING LIAISON
Authorized Official - Prefix:MS
Authorized Official - First Name:RORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-427-2000
Mailing Address - Street 1:120 E 86TH ST # 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1062
Mailing Address - Country:US
Mailing Address - Phone:212-427-1898
Mailing Address - Fax:
Practice Address - Street 1:120 E 86TH ST # 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1062
Practice Address - Country:US
Practice Address - Phone:212-427-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty