Individual
SAM SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14063
CT
363LG0600X
Gerontology Nurse Practitioner
Primary
14063
CT
Other
Enumeration date
10/29/2024
Last updated
03/26/2025
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