Individual ProviderNina SamuelStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address630 West 168th Street, Ph 8 East Room 105, New York, NY 10032(212) 305-5960PECOS EnrollmentBased on the most recent information from CMS, provider Nina Samuel does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1215722210Provider TypeIndividualFull NameSamuel, NinaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/10/2025Last Updated4/10/2025Contact InformationPractice LocationPractice Address630 West 168th Street, Ph 8 East Room 105, New York, NY 10032Phone(212) 305-5960FaxUnlisted FaxMailing LocationMailing Address630 West 168th Street, Ph 8 East Room 105, New York, NY 10032PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer