Provider Demographics
NPI:1386757466
Name:SAMANT, SUBHASH (MD)
Entity type:Individual
Prefix:
First Name:SUBHASH
Middle Name:
Last Name:SAMANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CATHARINE ST
Mailing Address - Street 2:P.O. BOX 550
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3100
Mailing Address - Country:US
Mailing Address - Phone:866-868-8417
Mailing Address - Fax:845-790-2675
Practice Address - Street 1:136 SAGAMORE RD
Practice Address - Street 2:DR DAVID & DR TSAI
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-4009
Practice Address - Country:US
Practice Address - Phone:914-337-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188351-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01398049Medicaid
G44147Medicare UPIN
NY83F001Medicare ID - Type Unspecified