Provider Demographics
NPI:1386619773
Name:SAMII, SORAYA M (MD)
Entity type:Individual
Prefix:DR
First Name:SORAYA
Middle Name:M
Last Name:SAMII
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 858 A410
Mailing Address - Street 2:PENN STATE HEART AND VASCULAR INSTITUTE
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033
Mailing Address - Country:US
Mailing Address - Phone:717-531-6853
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:PENN STATE HEART AND VASCULAR INSTITUTE
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033
Practice Address - Country:US
Practice Address - Phone:717-531-3907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070175L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101203557Medicaid
PA101203557Medicaid