Individual
SAMANTHA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
116 W 32ND ST FL 13, NEW YORK, NY 10001-3212
(646) 726-5795
Mailing address
448 E 186TH ST APT 2, BRONX, NY 10458-7710
(646) 726-5795
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
757107-1
NY
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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