Samuel Akhnoukh, MD

Individual provider Active NPI Orthopaedic Surgery of the Spine Physician · Stony Brook, NY

NPI 1730767401 · NPPES record last updated Oct 28, 2024

Key facts

NPI
1730767401
Entity type
Individual (NPI type 1)
Primary specialty
Orthopaedic Surgery of the Spine Physician 207XS0117X
License
325542 (NY)
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone
(631) 689-8333
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
325542NYMDOrthopaedic Surgery of the Spine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery of the Spine Physician 207XS0117X 325542 NY Yes

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-0001

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-0001

Other providers in Stony Brook, NY

All providers in Stony Brook, NY · Orthopaedic Surgery of the Spine Physician in New York

Sources for this page

Verify at the official NPI Registry.