Individual
ANSU SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2379 WEBSTER ST, NORTH BELLMORE, NY 11710-2124
(516) 728-4129
Mailing address
2379 WEBSTER ST, NORTH BELLMORE, NY 11710-2124
(516) 728-4129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
346024
NY
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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