Samantha Caruso, MS, ATC
Individual provider Active NPI Athletic Trainer · Saint James, NY
NPI 1902277809 · NPPES record last updated Sep 14, 2020
Key facts
- NPI
- 1902277809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 003237 (NY)
- Practice address
- 99 Lake Ave
Saint James, NY 11780-2930 - Phone
- (631) 334-4844
- NPI assigned
- Oct 18, 2015
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003237 | NY | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 003237 | NY | Yes |
Addresses
Primary practice location
99 Lake Ave
Saint James, NY 11780-2930
Mailing address
99 Lake Ave
Saint James, NY 11780-2930
Other providers in Saint James, NY
- Larissa Camacho
- Erin Nicole Cappelmann
- Carfora Medical Health Wellness PLLC
- Roxanne Gail Carfora
- Cynthia Carrucciu
- Gary Ward Cassidy
- James Joseph Cassin
- Morgan P Catalanotto
- Lisa A Catanzaro
- Christine Caulfield
All providers in Saint James, NY · Athletic Trainer 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 Sep 14, 2020. 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.