Provider Demographics
NPI:1821974494
Name:TAYLOR, SAMANTHA TRISHANA (NURSE)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:TRISHANA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CROTON AVE # H2W
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4212
Mailing Address - Country:US
Mailing Address - Phone:347-805-4922
Mailing Address - Fax:
Practice Address - Street 1:135 CROTON AVE # H2W
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4212
Practice Address - Country:US
Practice Address - Phone:347-805-4922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY834996163W00000X
NYF407291363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse