RUSSELL H SAMUEL (NPI# 1063473908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063473908 |
| Entity Type | Individual |
| Full Name | RUSSELL H SAMUEL |
| Credential | MD |
| Practice Address |
104 Forest Ave Glen Cove NY 11542 |
| Practice Telephone | 5167595406 |
| Practice Fax Number | 5167595537 |
| Mailing Telephone | 5167595406 |
| Mailing Fax Number | 5167595537 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2009-11-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 161000 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
104 FOREST AVE |
| City | GLEN COVE |
| State | NY |
| Zip Code | 11542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043754179 | Kaitlyn Krause | Physician Assistant | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2016-12-08 |
| 1346783586 | Medstation | Clinic/Center | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2016-11-21 |
| 1023447752 | Jaclyn Teresco | Physician Assistant | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2013-11-04 |
| 1043546732 | Czarina C Villarica | Physician Assistant | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2009-10-30 |
| 1992900583 | The Med Station PC | Internal Medicine | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2007-06-15 |
| 1912122136 | Jacqueline Allison Kielty | Physician Assistant | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2007-04-14 |
| 1063636280 | Jennifer D Roth | Physician Assistant | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2007-04-11 |
| 1710064761 | Debbie Feliciano | Emergency Medicine | 104 Forest Ave, Glen Cove, NY 11542-2015 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104468461 | Yvonne N Valcourt | Registered Nurse | 14 Burns Ave, Glen Cove, NY 11542 | 2019-10-08 |
| 1508419771 | Gregory Stephen Bonistalli | Audiologist | 70 Glen St Ste 100, Glen Cove, NY 11542 | 2019-07-17 |
| 1861954646 | Pulkit Malik | Student in an Organized Health Care Education/Training Program | Northwell Health Glen Cove Hospital, 101 St. Andrews Lane, Glen Cove, NY 11542 | 2019-04-02 |
| 1912498783 | Rays of Light Companion Care Agency LLC | Long Term Care Hospital | 70 Forest Ave # 2g, Glen Cove, NY 11542 | 2018-05-28 |
| 1164978391 | Nithin Kuruvilla | Pharmacist | 421 Glen Cove Road, East Hills, NY 11542 | 2016-08-28 |
| 1063879245 | Kerri A Sujeski | Physician Assistant | 104 Forest Avenue, Glen Cove, NY 11542 | 2016-01-19 |
| 1093110884 | Sherri Meagher | Social Worker | 130 Glen Street, Glen Cove, NY 11542 | 2014-10-23 |
| 1174946537 | Lori Seele | Psychologist | Ridge Drive, Connolly Elementary School, Glen Cove, NY 11542 | 2014-01-21 |
| 1255671210 | Wendy S Grossman | Speech-Language Pathologist | 2 Dosoris Lane, Deasy School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-27 |
| 1033459318 | Kristin Strelec | Social Worker | Seaman & Walnut Roads, Gribbin School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-22 |
| Find all providers in zip 11542 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1104463652 | Ohad Shimshon Bentur | General Practice | 450 E 63rd St Apt 3g, New York, NY 10065-7957 | 2019-12-03 |
| 1285278291 | Echo Clinical Associates LLC | General Practice | 56 Echo Ave., Ste 1, Miller Place, NY 11764-2454 | 2019-11-01 |
| 1710528583 | Debra Heverly | General Practice | 2315 Whirlpool St # 415, Niagara Falls, NY 14305-2413 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.