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Individual

NIDHIN SAMUEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1 LONG BEACH RD, ISLAND PARK, NY 11558-2254
(516) 432-0300
Mailing address
1 LONG BEACH RD, ISLAND PARK, NY 11558-2254

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403257-01
NY

Other

Enumeration date
10/01/2021
Last updated
12/14/2021
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