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NPI Code Detail

MEDICARE: SAMANTHA GOLD

MEDICARE: SAMANTHA GOLD
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
1363LC0200XCritical Care Medicine Nurse PractitionerAPRN.CNP.0031541OH

General Provider Information

NPI Number : 1770213308
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA GOLD
Provider Business Mailing Address
First Line : 1020 KENILWORTH AVE FRNT
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4474
Country : US
Telephone Number : 216-570-7410
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-3722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2022
Last Update Date : 06/28/2022

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Directions to “ SAMANTHA GOLD ” Practice Location

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