Basic Information
| Provider Information | |||||||||
| NPI: | 1558611814 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AUERBACH | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | ANP-C, WHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146052929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855462771 | ||||||||
| FaxNumber: | 5854547001 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146052929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855462771 | ||||||||
| FaxNumber: | 5854547001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2012 | ||||||||
| LastUpdateDate: | 04/02/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2277737 | MA | N | Nursing Service Providers | Registered Nurse | 363LA2200X | 306650 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 163W00000X | 672244 | NY | N | Nursing Service Providers | Registered Nurse |
No ID Information.