Provider Demographics
NPI:1659414571
Name:SAMTER, BAYLA (CNP)
Entity Type:Individual
Prefix:
First Name:BAYLA
Middle Name:
Last Name:SAMTER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:77 N CENTRE AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3923
Mailing Address - Country:US
Mailing Address - Phone:516-764-1303
Mailing Address - Fax:516-764-3618
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-764-1303
Practice Address - Fax:516-764-3618
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304497363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF304497OtherLICENSE