Individual ProviderJorge Luis SamanamudStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1468 Madison Avenue, Department Of Pathology 15th Floor, New York, NY 10029(646) 323-6541PECOS EnrollmentBased on the most recent information from CMS, provider Jorge Luis Samanamud 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 6 days ago.Profile DetailsProvider ID1225898471Provider TypeIndividualFull NameSamanamud, Jorge LuisTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date3/22/2024Last Updated3/22/2024Contact InformationPractice LocationPractice Address1468 Madison Avenue, Department Of Pathology 15th Floor, New York, NY 10029Phone(646) 323-6541FaxUnlisted FaxMailing LocationMailing Address1468 Madison Avenue, Department Of Pathology 15th Floor, New York, NY 10029PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer