Healthcare Provider Details

I. General information

NPI: 1295662385
Provider Name (Legal Business Name): SAMUELLE FRANCK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1050 CENTRAL AVE
WOODMERE NY
11598-1618
US

IV. Provider business mailing address

1420 FRONT ST
EAST MEADOW NY
11554-2222
US

V. Phone/Fax

Practice location:
  • Phone: 516-588-3200
  • Fax:
Mailing address:
  • Phone: 516-588-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF359454-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: