Provider Demographics
NPI:1396160610
Name:LALL SAMMY
Entity type:Organization
Organization Name:LALL SAMMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LALL
Authorized Official - Middle Name:BEHARRY
Authorized Official - Last Name:SAMMY
Authorized Official - Suffix:
Authorized Official - Credentials:AAS
Authorized Official - Phone:347-879-5731
Mailing Address - Street 1:8660 235TH CT
Mailing Address - Street 2:BELLEROSE
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2710
Mailing Address - Country:US
Mailing Address - Phone:347-879-5731
Mailing Address - Fax:
Practice Address - Street 1:8660 235TH CT
Practice Address - Street 2:BELLEROSE
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2710
Practice Address - Country:US
Practice Address - Phone:347-879-5731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY466405261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health