Provider Demographics
NPI:1659098432
Name:BOIDY, SAMANTHA A (RN)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:A
Last Name:BOIDY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 PIEDMONT PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9459
Mailing Address - Country:US
Mailing Address - Phone:336-289-8648
Mailing Address - Fax:
Practice Address - Street 1:233 SPRINT ST.
Practice Address - Street 2:FLOOR 13
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-651-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191729163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse