Provider Demographics
NPI:1407398480
Name:INESTI, SAMANTHA-MARIE
Entity Type:Individual
Prefix:
First Name:SAMANTHA-MARIE
Middle Name:
Last Name:INESTI
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 1:2146 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2606
Mailing Address - Country:US
Mailing Address - Phone:516-221-3030
Mailing Address - Fax:
Practice Address - Street 1:2146 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2606
Practice Address - Country:US
Practice Address - Phone:516-221-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker