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Individual

MS. MICHELLE KAREN SAMUELS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
121A WEST 20TH STREET, NEW YORK, NY 10011-2653
(212) 337-5665
(212) 337-5622
Mailing address
121A WEST 20TH STREET, NEW YORK, NY 10011-2653
(212) 337-5665
(212) 337-5622

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304192
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03293327
NY
01
A400037605
MEDICARE
NY
Enumeration date
06/02/2006
Last updated
08/12/2013
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