Individual provider · NPI-1
Samantha Hertzman
Registered Nurse, General Practice · Bay Shore, NY
NPI number1497675698
StatusActive
Last updated in NPPESJul 17, 2026
Details
- NPI
- 1497675698
- Entity type
- Individual (NPI-1)
- Name
- Samantha Hertzman
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 17, 2026
- Certification date
- Jul 17, 2026
- Last updated
- Jul 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | 691909 | NY | Yes |
Other names
- Samantha Avila (Former Name)
Practice location
301 E Main StBay Shore, NY 11706-8408
Phone 631-968-3162
Mailing address
562 S 14th StLindenhurst, NY 11757-4438
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