Individual
BRENDA SAMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 ELMONT RD UNIT 30218, ELMONT, NY 11003-1680
(646) 318-4400
Mailing address
PO BOX 30218, ELMONT, NY 11003-0218
(646) 318-4400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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