Basic Information
Provider Information
NPI: 1235413238
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAHLON
FirstName: SAMRINA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KAHLON
OtherFirstName: SAMRINA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D
OtherLastNameType: 1
Mailing Information
Address1: 2800 MARCUS AVE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110421113
CountryCode: US
TelephoneNumber: 5166226000
FaxNumber:  
Practice Location
Address1: 1901 1ST AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100297404
CountryCode: US
TelephoneNumber: 5515565656
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/10/2011
LastUpdateDate: 12/30/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X271177NYY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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