Individual
RANDALL B SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
520 CENTRAL AVE # VD, DUNKIRK, NY 14048-2515
(716) 710-8266
Mailing address
520 CENTRAL AVE # VD, DUNKIRK, NY 14048-2515
(716) 710-8266
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303144
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223765
—
NY
Enumeration date
06/30/2006
Last updated
04/17/2023
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