Provider Demographics
NPI:1588719538
Name:ARCE, SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:ARCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8906 135TH ST
Mailing Address - Street 2:SUITE 5T
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2828
Mailing Address - Country:US
Mailing Address - Phone:718-658-3355
Mailing Address - Fax:718-658-3356
Practice Address - Street 1:8906 135TH ST
Practice Address - Street 2:SUITE 5T
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2828
Practice Address - Country:US
Practice Address - Phone:718-658-3355
Practice Address - Fax:718-658-3356
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY155982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60531Medicare UPIN