Most Relevant Information
Provider Data
| NPI Number: | 1003356031 |
| Provider Name: | DANNIYA SAMUEL PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 020665 |
Most Important Dates
| Enumeration Date: | 02/23/2017 |
| Last Updated: | 02/23/2017 |
Provider Practice Location
327 BEACH 19TH ST
FAR ROCKAWAY
NY
116914423
Practice Location Phone/Fax
| Phone: | 7188697000 |
| Fax: |
Provider Mailing Location
299 SAVILLE RD
MINEOLA
NY
115011345
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |