Samantha Anderson

Individual provider Active NPI Registered Nurse · Mount Vernon, NY

NPI 1669860862 · NPPES record last updated Jan 15, 2015

Key facts

NPI
1669860862
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
691976 (NY)
Practice address
9 W Prospect Ave
Suite 310
Mount Vernon, NY 10550-2018
Phone
(914) 699-0022
Fax
(914) 699-2154
NPI assigned
Dec 23, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
691976NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Home Health Care Inc Past Accepting new patients
Absolute Home Health Care Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 691976 NY Yes

Addresses

Primary practice location

9 W Prospect Ave
Suite 310
Mount Vernon, NY 10550-2018

Mailing address

113 Morris St
Apt 3
Yonkers, NY 10705-1887
Phone (347) 957-1840

Other providers in Mount Vernon, NY

All providers in Mount Vernon, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.