Provider Demographics
NPI:1730530551
Name:LEMOINE, SAMANTHA SUE
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:SUE
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 HERITAGE LN APT A06
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1627
Mailing Address - Country:US
Mailing Address - Phone:978-895-1570
Mailing Address - Fax:
Practice Address - Street 1:61 HERITAGE LN APT A06
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1627
Practice Address - Country:US
Practice Address - Phone:978-895-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program