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General NPI Number Information
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NPI Number | 1104978014
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Entity Type | Organization
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Legal Business Name | SAMARITAN EMERGENCY MEDICAL SERVICES, PC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 1000 MONTAUK HWY
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City | WEST ISLIP
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State | NY
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Zip | 11795-4927
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Country | US
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Telephone | 631-376-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5913
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City | NEW YORK
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State | NY
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Zip | 10087-5913
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Country | US
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Telephone | 631-465-6225
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LORRAINE HUMMEL
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Credential |
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Telephone | 631-465-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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