Provider Demographics
NPI:1124053087
Name:PFEIFER, SAMANTHA M (MD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:M
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3701 MARKET ST
Mailing Address - Street 2:STE.800
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5502
Mailing Address - Country:US
Mailing Address - Phone:215-662-6315
Mailing Address - Fax:215-349-5512
Practice Address - Street 1:40 WORTH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2904
Practice Address - Country:US
Practice Address - Phone:646-962-2764
Practice Address - Fax:646-962-0325
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042192E207VE0102X, 207V00000X
NY267417207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001410513Medicaid
PA001410513Medicaid
PAF52939Medicare UPIN