Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 286893 | NY |
N | 207XS0117X | Orthopaedic Spine Surgeon | N5992 | TX |
NPI | 1053633040 |
---|---|
Provider Name | Yigal Samocha |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2010 |
Last Update Date | 19/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
286893 | NYS LICENSE (01) | NY |