Provider Demographics
NPI:1588369078
Name:ZUCKER, SAMUEL (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MARTINE AVE APT 605
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-4021
Mailing Address - Country:US
Mailing Address - Phone:845-531-1756
Mailing Address - Fax:
Practice Address - Street 1:25 MARTINE AVE APT 605
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-4021
Practice Address - Country:US
Practice Address - Phone:845-531-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer