Provider Demographics
NPI:1568358307
Name:SAMSON ERGUL, SILVIA
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:SAMSON ERGUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 BROADHOLLOW RD STE 402
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4899
Mailing Address - Country:US
Mailing Address - Phone:631-385-7780
Mailing Address - Fax:631-385-7795
Practice Address - Street 1:3 PONCHO DR
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-1409
Practice Address - Country:US
Practice Address - Phone:631-796-8311
Practice Address - Fax:631-796-8311
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool