Individual
SAMANTHA LOBASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGNP
Contact information
Practice address
4 W 2ND ST, RIVERHEAD, NY 11901-2702
(631) 548-6452
Mailing address
29 CENTRAL WOODS LN, BROOKHAVEN, NY 11719-9712
(631) 891-8954
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F310373-01
NY
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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