Provider Demographics
NPI:1861679409
Name:SAMARACH, LIOUDMILA
Entity type:Individual
Prefix:DR
First Name:LIOUDMILA
Middle Name:
Last Name:SAMARACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIOUDMILA
Other - Middle Name:
Other - Last Name:SAMARACH-BOBCHYNSKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 930163
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-0163
Mailing Address - Country:US
Mailing Address - Phone:917-561-2168
Mailing Address - Fax:
Practice Address - Street 1:9121 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4818
Practice Address - Country:US
Practice Address - Phone:917-561-2168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002381171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist