Provider Demographics
NPI:1760253710
Name:STRASSHEIM, SAMANTHA
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:
Last Name:STRASSHEIM
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 1:30 BROAD ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-4070
Mailing Address - Country:US
Mailing Address - Phone:774-279-1591
Mailing Address - Fax:
Practice Address - Street 1:30 BROAD ST UNIT 201
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-4070
Practice Address - Country:US
Practice Address - Phone:774-279-1591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2370115163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health