Healthcare Provider Details

I. General information

NPI: 1548630072
Provider Name (Legal Business Name): SAMANTHA INES SAVARINO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2015
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 DOUBLE HILL RD
BETHLEHEM CT
06751-1101
US

IV. Provider business mailing address

11 PASSAIC VALLEY RD
MONTVILLE NJ
07045-9635
US

V. Phone/Fax

Practice location:
  • Phone: 203-884-8652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberTAP8184
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7412
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: