Dias Samuel
Internal Medicine in Johnson City, NY. Individual provider (NPI-1).
NPI number1760913636
StatusActive
Last updated in NPPESJul 1, 2020
Details
- NPI
- 1760913636
- Entity type
- Individual (NPI-1)
- Name
- Dias Samuel
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2017
- Certification date
- Jul 1, 2020
- Last updated
- Jul 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 305645 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
33-57 Harrison StJohnson City, NY 13790-2107
Phone 607-763-6622
Mailing address
33 Lewis RdBinghamton, NY 13905-1048
Phone 607-729-8156
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