Basic Information
Provider Information | |||||||||
NPI: | 1922399518 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | D'ANNUNZIO | ||||||||
FirstName: | SAMANTHA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | PRICE | ||||||||
OtherFirstName: | SAMANTHA | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 800 WESTCHESTER AVE # 715 | ||||||||
Address2: |   | ||||||||
City: | RYE BROOK | ||||||||
State: | NY | ||||||||
PostalCode: | 105731354 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9146075730 | ||||||||
FaxNumber: | 9144571195 | ||||||||
Practice Location | |||||||||
Address1: | 1 THEALL RD # 202 | ||||||||
Address2: |   | ||||||||
City: | RYE | ||||||||
State: | NY | ||||||||
PostalCode: | 105801404 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9148488777 | ||||||||
FaxNumber: | 9148488778 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/29/2011 | ||||||||
LastUpdateDate: | 10/24/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 09/30/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 267955 | NY | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RC0200X | 267955 | NY | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 267955 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.