Most Relevant Information
Provider Data
| NPI Number: | 1003312810 |
| Provider Name: | SAMANTHA MEGAN WYCKOFF MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2084A0401X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 306481-01 |
Most Important Dates
| Enumeration Date: | 04/02/2018 |
| Last Updated: | 06/12/2023 |
Provider Practice Location
111 N 49TH ST
PHILADELPHIA
PA
191392718
Practice Location Phone/Fax
| Phone: | 2154712600 |
| Fax: |
Provider Mailing Location
525 E 68TH ST
NEW YORK
NY
100654870
Provider Mailing Phone/Fax
| Phone: | 7189203185 |
| Fax: | 7188823185 |