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1023505955
IMMACULA SAMSON
JAMAICA, NY
NPI
1023505955
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY 9854779)
Enumeration Date
2018-04-17
Last Update Date
2018-06-16
Business Address
IMMACULA SAMSON
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number: 718-883-3226
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Mailing Address
IMMACULA SAMSON
46 ASHLEY DR
VALLEY STREAM, NY 11580-2439
Phone number: 516-943-3952
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