Healthcare Provider Details

I. General information

NPI: 1912631045
Provider Name (Legal Business Name): SAMANTHA TAYLOR MASCETTI APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA TAYLOR BELL

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 CENTRAL AVE STE 100
ALBANY NY
12205-5329
US

IV. Provider business mailing address

1218 CENTRAL AVE STE 100
ALBANY NY
12205-5329
US

V. Phone/Fax

Practice location:
  • Phone: 716-431-2561
  • Fax:
Mailing address:
  • Phone: 716-431-2561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number352583
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: