Most Relevant Information
Provider Data
| NPI Number: | 1003268863 |
| Provider Name: | SAMANTHA IRENE BOGGS LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 261QA0600X |
| Specialty: | Clinic/Center |
| License Number: | 255708-1 |
Most Important Dates
| Enumeration Date: | 07/05/2016 |
| Last Updated: | 07/05/2016 |
Provider Practice Location
31 CHRIS MATT CT
BAY SHORE
NY
117066731
Practice Location Phone/Fax
| Phone: | 6319689196 |
| Fax: |
Provider Mailing Location
31 CHRIS MATT CT
BAY SHORE
NY
117066731
Provider Mailing Phone/Fax
| Phone: | 6319689196 |
| Fax: |