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General NPI Number Information
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NPI Number | 1811796667
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Entity Type | Individual
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Provider Name | SAMANTHA GRACE KOLBERT MSN, APRN,CPNP-PC/AC
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Gender | Female
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 462 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-9196
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Country | US
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Telephone | 212-562-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 148 E 24TH ST APT 5D
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City | NEW YORK
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State | NY
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Zip | 10010-3736
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Country | US
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Telephone | 203-984-4241
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 383794
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License Number State | NY
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