Basic Information
| Provider Information | |||||||||
| NPI: | 1194239913 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTIN | ||||||||
| FirstName: | SAMANTHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 616 VALEMONT DR | ||||||||
| Address2: | MONTEFIORE G100 | ||||||||
| City: | VERONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151472639 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 532 W PITTSBURGH ST | ||||||||
| Address2: | MONTEFIORE G100 | ||||||||
| City: | GREENSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156012239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248324000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2017 | ||||||||
| LastUpdateDate: | 06/15/2021 | ||||||||
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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 | 363L00000X | SP017695 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.