Individual
MRS. JEANETTE O SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
225 RABRO DRIVE EAST, HAUPPAUGE, NY 11788-4290
(631) 853-3020
(631) 853-3051
Mailing address
6 HICKORY ST, DEER PARK, NY 11729-7014
(631) 242-1520
(631) 940-3532
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F360016-1
NY
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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