Boulos Samuel Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025891 Issued in NY

Practice address

8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154

Phone

(718) 261-1000

Fax

(718) 261-0336

NPI assigned

Sep 21, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New York Medical & Diagnostic Center Inc

  • Family Medicine Physician
  • Kew Gardens, NY
  • NPI 1790771889
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1427044908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 KEW GARDENS RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151154",
            "telephone_number": "718-261-1000",
            "fax_number": "718-261-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8046 KEW GARDENS RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151154",
            "telephone_number": "718-261-1000",
            "fax_number": "718-261-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "BOULOS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Artin Sakhaee, DDS.
• Alisa Salbert
• Fareena Samad
• Miriam Samekhova
• Shazia Andleeb Sami, M.D
• Stanley Sanchez
• Elizabeth Victoria Savarese, LCSW
• Shirin Sayari, DDS
• Thirsa Gumela Scanlon, MASSAGE THERAPIST
• Melissa Scheetz

• Physical Therapist in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.