Provider Demographics
NPI:1972326742
Name:SAMUEL DOWE, TEVA
Entity type:Individual
Prefix:
First Name:TEVA
Middle Name:
Last Name:SAMUEL DOWE
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 1:12 CALIFORNIA AVE APT B508
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-2839
Mailing Address - Country:US
Mailing Address - Phone:914-435-6888
Mailing Address - Fax:
Practice Address - Street 1:12 CALIFORNIA AVE APT B508
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-2839
Practice Address - Country:US
Practice Address - Phone:914-435-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY875919163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse