Provider Demographics
NPI:1235717182
Name:MCGUIRE, SAMANTHA K
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:K
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 ROUTE 306
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-2111
Mailing Address - Country:US
Mailing Address - Phone:845-596-8162
Mailing Address - Fax:
Practice Address - Street 1:7 NEW LAKE RD
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-1868
Practice Address - Country:US
Practice Address - Phone:845-809-8176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist