Lagace, Samantha L
Lagace, Samantha L is an individual health care provider with primary practice located at 2508 Western Ave , Altamont NY 12009-9485. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Lagace, Samantha L can be contacted via phone (518) 690-0177.Contact Information
Primary practice address
2508 Western Ave
Altamont NY 12009-9485
Phone: (518) 690-0177
Fax: (518) 690-0169
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 014851 | New York |
Profile Details
| NPI number | 1790073724 |
|---|---|
| LBN Legal business name | Lagace, Samantha L |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2011 |
| Last updated | May 15th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790073724 | NPPES |
| New York | MEDICAID | 03406526 |
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