Individual
GIA SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6217 GARDENIA ST, PHILADELPHIA, PA 19144-1608
(484) 903-5896
Mailing address
13305 228TH ST, LAURELTON, NY 11413-1746
(718) 527-1805
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN782298
PA
164W00000X
Licensed Practical Nurse
321856-1
NY
Other
Enumeration date
05/20/2015
Last updated
04/08/2025
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