Individual provider · Type 1 NPI

Samantha Jill Graham, NP

Gerontology Nurse Practitioner · Boston, MA

NPI number 1629580154 Active

Practice location

830 Harrison Avenue, 3rd Fl, Moakley Bldg
Boston, MA 02118-2905

Fax (617) 638-5756

Mailing address

960 Massachusetts Ave, Fl 2
Boston, MA 02118-2690

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X2320171 (MA)
Gerontology Nurse Practitioner Primary 363LG0600XRN2320171 (MA)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1629580154

Samantha Jill Graham, NP's National Provider Identifier is 1629580154, issued on Oct 24, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Boston, MA. The record was last updated on Oct 28, 2026.