Provider Demographics
NPI:1730836073
Name:VEDA HOUSE, LLC
Entity type:Organization
Organization Name:VEDA HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER IN PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCCA
Authorized Official - Suffix:
Authorized Official - Credentials:PHMNP-BC
Authorized Official - Phone:518-444-4482
Mailing Address - Street 1:6 MOUNTAIN LEDGE STE 2
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NY
Mailing Address - Zip Code:12831-2539
Mailing Address - Country:US
Mailing Address - Phone:518-444-4482
Mailing Address - Fax:518-444-4509
Practice Address - Street 1:6 MOUNTAIN LEDGE STE 2
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:NY
Practice Address - Zip Code:12831-2539
Practice Address - Country:US
Practice Address - Phone:518-444-4482
Practice Address - Fax:518-444-4509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty