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General NPI Number Information
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NPI Number | 1548996150
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Entity Type | Individual
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Provider Name | SAMUEL STAMPLEY III ATC, PES, CES
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Gender | Male
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 1000 HEMPSTEAD TPKE HEMPSTEAD NY 11549
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City | HEMPSTEAD
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State | NY
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Zip | 11549-0001
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Country | US
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Telephone | 516-463-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 14060 BEECH AVE APT 5F
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City | FLUSHING
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State | NY
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Zip | 11355-2831
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Country | US
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Telephone | 214-425-7919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003580
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License Number State | NY
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