Provider Demographics
NPI:1508363367
Name:RUE, SAMANTHA LYNN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:LYNN
Last Name:RUE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 OLD ROUTE 9W STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5485
Mailing Address - Country:US
Mailing Address - Phone:845-549-1010
Mailing Address - Fax:845-565-5027
Practice Address - Street 1:92 OLD ROUTE 9W STE 200
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5485
Practice Address - Country:US
Practice Address - Phone:845-549-1010
Practice Address - Fax:845-565-5027
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily