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Samantha I Blair

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

451 Clarkson Ave, Brooklyn, NY 11203-2054

PECOS Enrollment

This provider is enrolled in PECOS as SAMANTHA BLAIR.

Based on the most recent information from CMS, provider Samantha I Blair is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1700223260
Provider Type
Individual
Full Name
Blair, Samantha I
Title
Ms.
Credential
NURSE PRACTITIONER

Gender
Female
Sole Proprietor
No
Enumeration Date
5/23/2013
Last Updated
10/28/2021

Contact Information

Practice Location

451 Clarkson Ave, Brooklyn, NY 11203-2054

(718) 245-4600

Unlisted Fax

Mailing Location

150 E 55th St, Brooklyn, NY 11203-3770

(718) 630-7000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 346802 New York

Samantha I Blair

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Paul-Denis, Mirlande

Sherwood, Jeannine Marguerite

Anderson, Marlene O

Pryce-Carby, Yanique

Thomas, Mavis

Denniston, Brittany Lauren

Griffith-Roberts, Keisandra

Lokoyi, Abiola

Campbell, Michael

Wilson, Miriam Rebecca