SAMUEL S WILBURN (NPI# 1396355327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396355327 |
| Entity Type | Individual |
| Full Name | SAMUEL S WILBURN |
| Credential | NP |
| Practice Address |
75 Jackson St Apt 1 Brooklyn NY 11211-2245 |
| Practice Telephone | 7133200191 |
| Mailing Telephone | 7133200191 |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
309784 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NEW YORK STATE DEPARTMENT OF EDUCATION | 309784 | 01 |
| Street Address |
75 JACKSON ST APT 1 |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11211-2245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265068407 | Kent Russell Siady | Physical Therapist | 240 South 3rd.street, Brooklyn, NY 11211 | 2020-03-19 |
| 1285268623 | Rafieh Pharmacy | Pharmacy | 70 Lee Ave Store, Brooklyn, NY 11211 | 2020-02-25 |
| 1306314471 | Incontrol Nutrition | Dietitian, Registered | 378 Union Avenue, Office C, Brooklyn, NY 11211 | 2018-11-07 |
| 1073027751 | Alicia Perez | Counselor | 141 South 5th Street, Office West #6, Brooklyn, NY 11211 | 2017-11-16 |
| 1003350265 | Hani Alsergani | Internal Medicine | King Faisal Specialist Hospital. Heart Center., Takasussi Street. Mbc 16, Riyadh, CENTRAL 11211 | 2016-12-07 |
| 1043769805 | Jennifer S Budhan | Social Worker | 378 Union Ave, Office B, Brooklyn, NY 11211 | 2016-09-21 |
| 1174978613 | Amor Siozon | Physical Therapist | 185 Marcy Avenue, Brooklyn, NY 11211 | 2016-05-03 |
| 1649656638 | Albalis Chavez | Specialist | 334 South Third Street. Apt. 3c, Brooklyn, NY 11211 | 2015-08-03 |
| 1114315033 | Maja Mirkovic | Dietitian, Registered | 378 Union Avenue, Office C, Brooklyn, NY 11211 | 2014-12-30 |
| 1447687033 | Sarah Maria Johnson | Counselor | 190 S8 St. Apt. 14, Brooklyn, NY 11211 | 2013-09-27 |
| Find all providers in zip 11211 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334100 | Yin Kong | Nurse Practitioner | 7105 3rd Avenue, #523, 7105 3rd Avenue, #52, Brooklyn, NY 11209-1308 | 2020-10-21 |
| 1922612944 | Rosemarie Elizabeth Crosdale | Nurse Practitioner | 9019 Avenue A, Brooklyn, NY 11236-1208 | 2020-09-08 |
| 1144832247 | Marise Richard | Nurse Practitioner | 1106 E 57th St, Brooklyn, NY 11234-3312 | 2020-08-19 |
| 1487264008 | Dina Levkova | Nurse Practitioner | 303 Webster Ave Apt 2f, Brooklyn, NY 11230-1256 | 2020-08-07 |
| 1972113694 | Winsome Elizabeth Benain | Nurse Practitioner | 9621 Avenue B, Brooklyn, NY 11236-1321 | 2020-08-06 |
| 1710595335 | Aimee Huang | Nurse Practitioner | 96 Bay 10th St, Brooklyn, NY 11228-3702 | 2020-07-20 |
| 1700494812 | Jessica B Schwab | Nurse Practitioner | 75 Jackson St Apt 1fh, Brooklyn, NY 11211-2245 | 2020-07-15 |
| 1225654916 | Leasha Lindsay | Nurse Practitioner | 1214 E 87th St, Brooklyn, NY 11236-4929 | 2020-06-18 |
| 1760002323 | Satchell-lee Tyrell | Nurse Practitioner | 537 Rogers Ave, Brooklyn, NY 11225-5445 | 2020-04-23 |
| 1659900116 | Sherry Stephen | Nurse Practitioner | 1428 E 98th St, Brooklyn, NY 11236-5044 | 2020-04-06 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.