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General NPI Number Information
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NPI Number | 1740820943
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Entity Type | Individual
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Provider Name | SAMANTHA MARIE CHOLEWA PNP
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Gender | Female
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 26901 76TH AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1433
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Country | US
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Telephone | 718-470-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 CHESTNUT ST APT 506
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City | PHILADELPHIA
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State | PA
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Zip | 19103-3377
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Country | US
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Telephone | 214-681-3270
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | SP021197
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 383077
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License Number State | NY
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