Basic Information
| Provider Information | |||||||||
| NPI: | 1457382814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMUEL | ||||||||
| FirstName: | RANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1561 LONG POND RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146264117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857237765 | ||||||||
| FaxNumber: | 5857237735 | ||||||||
| Practice Location | |||||||||
| Address1: | 1561 LONG POND RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146264117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857237765 | ||||||||
| FaxNumber: | 5857237735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 06/24/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZD0900X | 213344 | NY | Y | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZP0102X | 213344 | NY | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.