Healthcare Provider Details

I. General information

NPI: 1962336834
Provider Name (Legal Business Name): SAMANTHA ANN TODARO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4456 AMBOY RD
STATEN ISLAND NY
10312-3897
US

IV. Provider business mailing address

75 CUBA AVE
STATEN ISLAND NY
10306-4907
US

V. Phone/Fax

Practice location:
  • Phone: 718-967-0490
  • Fax:
Mailing address:
  • Phone: 718-734-7109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: