Basic Information
| Provider Information | |||||||||
| NPI: | 1639331804 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMANDAR | ||||||||
| FirstName: | STEVE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 813 MAIDEN CHOICE LN | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212283679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104022258 | ||||||||
| FaxNumber: | 4102047279 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 MARCUS AVE STE 2W15 | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110421005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552014988 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA08744500 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.