Provider Demographics
NPI:1376015909
Name:HOELZLE, SAMUEL (RN)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:HOELZLE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 BROADWAY FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9580
Mailing Address - Country:US
Mailing Address - Phone:212-443-1000
Mailing Address - Fax:
Practice Address - Street 1:726 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9616
Practice Address - Country:US
Practice Address - Phone:212-443-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY706633163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege HealthGroup - Multi-Specialty