SAMANTHA DERISO

STATEN ISLAND, NY
NPI1790910131
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  295075)
Enumeration Date2009-05-28
Last Update Date2009-05-28
Business Address
-- SAMANTHA DERISO LPN
1477 HYLAN BLVD
STATEN ISLAND, NY 10305-1906
Phone number: 718-979-6900
Mailing Address
-- SAMANTHA DERISO LPN
316 ADAMS AVE
STATEN ISLAND, NY 10306-5216
Phone number: 917-495-9906