Individual
ANISHA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10460 QUEENS BLVD, APT 16C, FOREST HILLS, NY 11375-7318
(516) 451-5658
Mailing address
10460 QUEENS BLVD, APT 16C, FOREST HILLS, NY 11375-7318
(516) 451-5658
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312268
NY
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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