Samanta Boursiquot, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

328485 Issued in NY

Practice address

7 Bismark Ave
Valley Stream, NY 11581-1455

Phone

(516) 263-4467

NPI assigned

Dec 6, 2018

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

State licenses

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1952872681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BISMARK AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811455",
            "telephone_number": "516-263-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BISMARK AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811455",
            "telephone_number": "516-263-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURSIQUOT",
        "first_name": "SAMANTA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "328485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janny Bonhomme, MEDICAL EQUIPMENT
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• Aishah Bovell
• Fallone Bovell
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• Angeleta L Boyce, M.A.
• Keith Boyd

• Licensed Practical Nurse in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.