National Provider Identifier

Sanjay Samuel, MD

Sanjay Samuel, MD is listed in the NPPES registry with a primary specialty of General Practice Physician in Brockport, NY and a listed phone number of (585) 637-3131.

NPI 1417180852Brockport, NYGeneral Practice Physician

Profile Overview

NPI
1417180852
Provider Type
Individual
Primary Specialty
General Practice Physician
Enumeration Date
September 02, 2009
Last Updated
September 13, 2017

Practice Location

  • 156 West Ave
  • Brockport, NY 14420-1229

Phone: (585) 637-3131

Specialties

  • General Practice Physician (208D00000X)
  • Obstetrics & Gynecology Physician (207V00000X)
Full Record
NPI
1417180852
Entity Type
Individual
Last Name
Samuel
First Name
Sanjay
Name Prefix
Dr.
Credential
MD
Mailing Street Address
156 West Ave
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-1229
Mailing Country
US
Mailing Phone
(585) 637-3131
Practice Street Address
156 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1229
Practice Country
US
Practice Phone
(585) 637-3131
Practice Fax
(585) 395-6036
Enumeration Date
September 02, 2009
Last Updated
September 13, 2017
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Physician (208D00000X), Obstetrics & Gynecology Physician (207V00000X)