Active NPI
Raphael Samaniego
- Student in an Organized Health Care Education/Training Program
- Brox, NY
National Provider Identifier
1710506019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1400 Pelham Parkway S.
Brox, NY 10461 - Phone
- (718) 918-3419
- Fax
- (718) 918-6147
- NPI assigned
- Apr 16, 2020
- Last updated
- Apr 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary |
Addresses
Primary practice location
1400 Pelham Parkway S.
Brox, NY 10461
Mailing address
1297 Franklin St
Coquitlau, BRITISH COLUMBIA V3B 6N6
CA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1710506019",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "1297 FRANKLIN ST",
"city": "COQUITLAU",
"state": "BRITISH COLUMBIA",
"postal_code": "V3B 6N6"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PARKWAY S.",
"city": "BROX",
"state": "NY",
"postal_code": "10461",
"telephone_number": "718-918-3419",
"fax_number": "718-918-6147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMANIEGO",
"first_name": "RAPHAEL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-16",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.