| Doctor Name: | MS. ALIYAMMA SAMUEL |
| NPI Number: | 1023114352 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | F303426 |
| Business Practice Address: | 82-68 164th St Jamaica, NY - 114321121 |
| Business Phone Number: | 7188833225 |
| Business Fax Number: | 7188836193 |
| Mailing Address: | 79-01 Broadway, D1-01 ELMHURST |
| State: | NY |
| Postal Code: | 113731329 |
| Phone Number: | 7183341920 |
| Fax Number: | 7183345958 |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | F303426 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |