MEDICARE: SAMANTHA JO CHICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	054783	NY

General Provider Information

NPI Number	:	1023995628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA JO CHICK

Provider Business Mailing Address
First Line	:	560 82ND ST
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14304-2373
Country	:	US
Telephone Number	:	716-438-8567
Fax Number	:

Provider Business Practice Location Address
First Line	:	888 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-1111
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	08/18/2025

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Directions to “ SAMANTHA JO CHICK ” Practice Location

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