Individual
JENNIFER MEAD-SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
53 W MAIN ST, VICTOR, NY 14564-1198
(585) 924-0690
Mailing address
53 W MAIN ST, VICTOR, NY 14564-1198
(585) 924-0690
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005008
NY
363AM0700X
Medical Physician Assistant
5008
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176876BF
PREFERRED CARE
NY
01
—
P019005008
BLUE CHOICE
NY
Enumeration date
06/07/2006
Last updated
07/05/2023
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