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General NPI Number Information
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NPI Number | 1750027421
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Entity Type | Individual
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Provider Name | SAMANTHA MORGAN BUCK LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 11835 QUEENS BLVD FL 6
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City | FOREST HILLS
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State | NY
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Zip | 11375-7211
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Country | US
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Telephone | 610-348-4524
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Fax |
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Provider Business Mailing Address
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Address Line | 171 ROGERS AVE APT 3C
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City | BROOKLYN
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State | NY
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Zip | 11216-4287
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Country | US
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Telephone | 610-348-4524
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 116720
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License Number State | NY
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