Provider Demographics
NPI:1992820880
Name:FOX, SAMUEL
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:SAMUEL
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 WINDEMERE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1532
Mailing Address - Country:US
Mailing Address - Phone:516-993-0389
Mailing Address - Fax:
Practice Address - Street 1:1 WINDEMERE DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1532
Practice Address - Country:US
Practice Address - Phone:516-993-0389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184980207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology