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NPI Code Detail

MEDICARE: SAMANTHA NOELLE MORREALE NP

MEDICARE: SAMANTHA NOELLE MORREALE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner307256NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1307256OTHERNYNEW YORK STATE LICENSE

General Provider Information

NPI Number : 1023402690
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA NOELLE MORREALE NP
Provider Business Mailing Address
First Line : 2931 MILITARY RD
Second Line :
City : NIAGARA FALLS
State : NY
Zip : 14304-1251
Country : US
Telephone Number : 716-298-4869
Fax Number : 888-847-3060
Provider Business Practice Location Address
First Line : 2931 MILITARY RD
Second Line :
City : NIAGARA FALLS
State : NY
Zip : 14304-1251
Country : US
Telephone Number : 716-298-4869
Fax Number : 888-847-3060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2015
Last Update Date : 03/24/2015

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