Samantha Mackenzie McCrory
Individual provider Active NPI Pediatric Registered Nurse · Stormville, NY
NPI 1336801596 · NPPES record last updated Oct 6, 2021
Key facts
- NPI
- 1336801596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- 775956 (NY)
- Practice address
- 179 Seaman Rd
Stormville, NY 12582-5111 - Phone
- (845) 240-4464
- NPI assigned
- Oct 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 775956 | NY | MD | Pediatric Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 775956 | NY | Yes |
Addresses
Primary practice location
179 Seaman Rd
Stormville, NY 12582-5111
Mailing address
179 Seaman Rd
Stormville, NY 12582-5111
Phone (845) 240-4464
Other providers in Stormville, NY
- Richard Steven Lieske
- Chris Lombardo II
- Marisa Marinelli
- Colleen Martin
- Leotha Emelia Maynard
- Patrick Charles Mullaly
- Cathleen Ann Murphy
- Debra Nascarella Hawley
- Samantha Nash
- Silvia Marita Oblitas
All providers in Stormville, NY · Pediatric Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.