Samuel Boi Addo, MD. PHD
Individual provider Active NPI Pediatrics Physician · Johnson City, NY
NPI 1497738041 · NPPES record last updated Nov 16, 2011
Key facts
- NPI
- 1497738041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 209908 (NY)
- Practice address
- 269 Riverside Dr
Johnson City, NY 13790-2726 - Phone
- (607) 729-9327
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209908 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chenango Memorial Hospital, Inc. | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 209908 | NY | Yes |
Addresses
Primary practice location
269 Riverside Dr
Johnson City, NY 13790-2726
Mailing address
909 Marguerite CT
Vestal, NY 13850-3817
Phone (607) 723-2393
Other providers in Johnson City, NY
- Ahmad Abugharbieh
- Tairla Ackley
- Marleny Margarita Acosta
- Acousticon Hearing Aid Center
- Acousticon of Binghamton, Inc
- Advanced Hearing Solutions
- Dhruv Agneshwar
- Rana Zaheer Ahmad
- Bilal Ahmed
- Mahmood A Ahmed
All providers in Johnson City, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.