Healthcare Provider Details

I. General information

NPI: 1730883711
Provider Name (Legal Business Name): SAMELVIE SARGUSINGH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 BAY RIDGE PKWY STE LL
BROOKLYN NY
11209-3309
US

IV. Provider business mailing address

70 S MUNN AVE APT 514
EAST ORANGE NJ
07018-4310
US

V. Phone/Fax

Practice location:
  • Phone: 929-200-3049
  • Fax:
Mailing address:
  • Phone: 718-791-4757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: