Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 242568 | NY |
NPI | 1093848202 |
---|---|
Provider Name | Dr. Rubina Samad |
First Address | Jackson Heights, NY 11372-3440 |
Second Address | Flushing, NY 11355-2205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |