Irisdene Doreen Samuel, RN BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

431150-1 Issued in NY

Practice address

175-22 139TH Road
Jamaica, NY 11434

Phone

(718) 525-0606

NPI assigned

Apr 5, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1598021396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175-22 139TH ROAD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11434",
            "telephone_number": "718-525-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175-22 139TH ROAD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11434",
            "telephone_number": "718-525-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "IRISDENE",
        "middle_name": "DOREEN",
        "name_prefix": "Miss",
        "credential": "RN BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "431150-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Immacula Samson
• Sharece D Samu, LPN
• Aliyamma Samuel, NP
• Beena Samuel, SR. PHARMACIST
• Farah Samuel
• Ann Marie Samuels, MSC (SPECIAL ED)
• Jonathan Evan Samuels, MD
• Kerrine A Samuels
• Maryia Samus
• Siena Sanches

• Registered Nurse in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.