Individual provider · Type 1 NPI

Samantha Petie-Judge

Licensed Practical Nurse · Port Jefferson Station, NY

NPI number 1033475744 Active

Practice location

1010 Route 112
Port Jefferson Station, NY 11776-3387

Call (631) 473-1200 Map

Mailing address

8 Rodney St
Port Jefferson Station, NY 11776-3711

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X259896 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1033475744

Samantha Petie-Judge's National Provider Identifier is 1033475744, issued on Apr 6, 2012. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Apr 6, 2012.