Individual
SAMANTHA DMYTROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3911 RICHMOND AVE, STATEN ISLAND, NY 10312-5110
(718) 948-3232
Mailing address
3911 RICHMOND AVE, STATEN ISLAND, NY 10312-5110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131624228
—
NY
Enumeration date
11/09/2020
Last updated
06/09/2025
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