Provider Demographics
NPI:1558611814
Name:AUERBACH, SAMANTHA L (ANP-C, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:AUERBACH
Suffix:
Gender:F
Credentials:ANP-C, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-2929
Mailing Address - Country:US
Mailing Address - Phone:585-546-2771
Mailing Address - Fax:585-454-7001
Practice Address - Street 1:114 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-2929
Practice Address - Country:US
Practice Address - Phone:585-546-2771
Practice Address - Fax:585-454-7001
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2277737163W00000X
NY306650363LA2200X
NY672244163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse