1386619773 NPI number — DR. SORAYA M SAMII MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386619773 NPI number — DR. SORAYA M SAMII MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAMII
Provider First Name:
SORAYA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386619773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 858 A410
Provider Second Line Business Mailing Address:
PENN STATE HEART AND VASCULAR INSTITUTE
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-531-6853
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 UNIVERSITY DR
Provider Second Line Business Practice Location Address:
PENN STATE HEART AND VASCULAR INSTITUTE
Provider Business Practice Location Address City Name:
HERSHEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-531-3907
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD070175L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101203557 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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