Provider Demographics
NPI:1992073605
Name:SAMI ABDEL SAYED RAPHAEL INC
Entity type:Organization
Organization Name:SAMI ABDEL SAYED RAPHAEL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAPHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-282-2388
Mailing Address - Street 1:1329 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1919
Mailing Address - Country:US
Mailing Address - Phone:716-282-2388
Mailing Address - Fax:716-282-0036
Practice Address - Street 1:1329 PINE AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1919
Practice Address - Country:US
Practice Address - Phone:716-282-2388
Practice Address - Fax:716-282-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1977561208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty