Healthcare Provider Details

I. General information

NPI: 1275453284
Provider Name (Legal Business Name): SAMANTHA JOANN PLACIDO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA JOANN FUTREL RN

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 GAGE RD
BREWSTER NY
10509-4829
US

IV. Provider business mailing address

489 GAGE RD
BREWSTER NY
10509-4829
US

V. Phone/Fax

Practice location:
  • Phone: 405-630-0869
  • Fax:
Mailing address:
  • Phone: 405-630-0869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2510466
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2510466
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: