Healthcare Provider Details

I. General information

NPI: 1649100637
Provider Name (Legal Business Name): PAMALA SHROH-SAMMONS NURSE PRACTITIONER IN ADULT HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 ROSA RD
SCHENECTADY NY
12309-3717
US

IV. Provider business mailing address

10 ALBERT ST
TROY NY
12180-7886
US

V. Phone/Fax

Practice location:
  • Phone: 518-231-4702
  • Fax:
Mailing address:
  • Phone: 518-231-4702
  • Fax: 518-231-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAMALA SHROH-SAMMONS
Title or Position: NP/OWNER
Credential: NP
Phone: 518-231-4702