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WYLD SAMUEL WILLIAM

Debarred entity

WYLD SAMUEL WILLIAM is a person of interest. They have not been found on international sanctions lists.

Type	Person				[sources]
Name	Samuel W. Wyld · WYLD SAMUEL WILLIAM				[sources]
Birth date	not available				[sources]
Nationality	not available				[sources]
Country	United States				[sources]
First name	Samuel				[sources]
ID Number	`00023375` · `MA059106`				[sources]
Last name	Wyld				[sources]
Middle name	W.				[sources]
NPI	`1558882779`				[sources]
Sector	Physician Assistant				[sources]
Title	PA-C · Physician Assistant				[sources]
Address	(NY), (NY)				[sources]
Last change	2025-02-20	Last processed	2025-11-15	First seen	2024-09-02

Sanctions
Country	Authority	Program	Start date	End date
United States	Department of Human Services		2021-07-27	-

Address
Full address	Country
(NY), (NY) · NY, NY	United States

Medical providers who are precluded from participation in the Medical Assistance Program

United States · DHS

Medical providers deemed ineligible to participate in New York State's Medicaid program.

United States · OMIG

Source data IDs: us-medny-423f651cd6c3eccc1feef8cefee04c85575838b3 · us-medpa-5227b47fc3401b67779d7bec131287a3abb37970

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