Healthcare Provider Details

I. General information

NPI: 1275658627
Provider Name (Legal Business Name): SAMARA M GABREE ANP-BC, AAHIVS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SLINGERLAND ST
ALBANY NY
12202-1229
US

IV. Provider business mailing address

201 STEEPLE WAY
SCHENECTADY NY
12306-2551
US

V. Phone/Fax

Practice location:
  • Phone: 518-449-3581
  • Fax: 518-426-3662
Mailing address:
  • Phone: 518-423-2986
  • Fax: 518-426-3662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304575
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: