Samples, Jennifer L

Samples, Jennifer L is an individual health care provider with primary practice located at 111 Maltese Dr , Middletown NY 10940-2115. 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. Samples, Jennifer L can be contacted via phone (845) 342-4774.

Contact Information

Primary practice address
111 Maltese Dr Middletown NY 10940-2115
Phone: (845) 342-4774
Fax: (845) 342-8741
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 009761 New York

Profile Details

NPI number 1427020056
LBN Legal business name Samples, Jennifer L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Aug 2nd, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427020056 NPPES
New York Other 009761 LICENSE

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