Provider Demographics
NPI:1649714965
Name:WHITNEY, SAMANTHA MORGAN (ATC)
Entity type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:MORGAN
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-3715
Mailing Address - Country:US
Mailing Address - Phone:631-539-4767
Mailing Address - Fax:
Practice Address - Street 1:529 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-3715
Practice Address - Country:US
Practice Address - Phone:631-539-4767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program