DR. SANJAY SAMUEL MD NPI 1417180852

NPI Information

  • NPI: 1417180852
  • Provider Name: DR. SANJAY SAMUEL, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 156 WEST AVE
    BROCKPORT, NY
    ZIP 14420
  • Phone: (585) 637-3131

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NPI Details

DR. Sanjay Samuel, MD is a general practice in Brockport, NY. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Sanjay Samuel, MD NPI is 1417180852. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

156 WEST AVE
BROCKPORT, NY
ZIP 14420-229
Phone: (585) 637-3131
Fax: (585) 395-6036

The NPI 1417180852 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/2/2009 and was last updated on 9/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology254678NEW YORKNo
2208D00000XGeneral Practice254678NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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