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SAMUEL TESFAYE SHIFERAW M.D.
NPI 1124811070
Student in an Organized Health Care Education/Training Program in New York, NY

Active since May 23, 2025
1545 ATLANTIC AVENUE, NEW YORK, NY 11213(718) 613-4063 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 10, 2025, May 23, 2025 (2 updates tracked since 2025).

About Samuel Tesfaye Shiferaw M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL TESFAYE SHIFERAW M.D. (NPI 1124811070) is an individual student in an organized health care education/training program in New York, New York and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1124811070
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL TESFAYE SHIFERAWCredential: M.D.
Location Address1545 ATLANTIC AVENUENew York, NY 11213
Mailing Address1545 Atlantic AvenueNew York, NY 11213 · (718) 613-4063
Phone(718) 613-4063
Sole ProprietorNo
Enumeration DateMay 23, 2025
Last NPPES UpdateSeptember 10, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
✔ NPI 1124811070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1545 ATLANTIC AVENUE, New York, NY 11213
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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLEN WOLDEGIORGIS NEDASSA M.D.
Student in an Organized Health Care Education/Training Program
1545 ATLANTIC AVENUE
BROOKLYN, NY 11213
Kings County (718) 613-4063
MR. MANLEY MORRISON III LMSW
Social Worker (Clinical)
1545 ATLANTIC AVENUE
BROOKLYN, NY 11213
Kings County (718) 613-7260
MS. FRANTZIE JEAN P.A
Physician Assistant
1545 ATLANTIC AVENUE
BROOKLYN, NY 11213
Kings County (718) 613-4858
INTERFAITH EMERGENCY MEDICINE, P.C.
Emergency Medicine
1545 ATLANTIC AVENUE, FACULTY PRACTICE
BROOKLYN, NY 11213
Kings County (718) 240-8352
INTERFAITH PROFESSIONAL PHYSICIAN SERVICES, P.C.
Allergy & Immunology (Allergy)
1545 ATLANTIC AVENUE, FACULTY PRACTICE
BROOKLYN, NY 11213
Kings County (718) 240-8352
THE BROOKDALE HOSPITAL MEDICAL CENTER
General Acute Care Hospital
1545 ATLANTIC AVENUE
BROOKLYN, NY 11213
Kings County (716) 222-7692
INTERFAITH PSYCHIATRY SERVICES, P.C.
Psychiatry & Neurology (Psychiatry)
1545 ATLANTIC AVENUE, FACULTY PRACTICE
BROOKLYN, NY 11213
Kings County (718) 240-8352
DR. MICHAEL LEGASION MD
Hospitalist
1545 ATLANTIC AVENUE, INTERFAITH MEDICAL CENTER,
BROOKLYN, NY 11213
Kings County (202) 615-1165

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Shiferaw's NPI number?

The NPI number for Samuel Shiferaw is 1124811070. It was assigned to this individual provider in the NPPES registry on May 23, 2025.

Where is Samuel Shiferaw located?

Samuel Shiferaw practices at 1545 Atlantic Avenue, New York, NY 11213. The listed phone number is (718) 613-4063.

What is Samuel Shiferaw's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Samuel Shiferaw was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.