Individual ProviderLall SammyRegistered NurseNursing Service ProvidersPractice Address8660 235th Ct, Queens Village, Queens Village, NY 11427-2710(347) 879-5731PECOS EnrollmentBased on the most recent information from CMS, provider Lall Sammy does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1013332030Provider TypeIndividualFull NameSammy, LallCredentialREGISTER NURSEGenderMaleSole ProprietorYesEnumeration Date2/27/2014Last Updated2/27/2014Contact InformationPractice LocationPractice Address8660 235th Ct, Queens Village, Queens Village, NY 11427-2710Phone(347) 879-5731FaxUnlisted FaxMailing LocationMailing Address8660 235th Ct, Queens Village, Queens Village, NY 11427-2710Phone(347) 879-5731FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense466405New York