| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SAMANTHA RYLLO | 1477230308 | 2023-08-13 |
Samantha Ryllo is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477230308. Registration indicates Samantha Ryllo is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| Entity Type | Individual |
| Provider Name | Samantha Ryllo PA |
| Practice Office Address | 1901 1ST AVE NEW YORK, NY US |
| Practice Office Telephone | 2124236262 |
| Mailing Address | 1901 1ST AVE NEW YORK, NY 100297491 US |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 363AS0400X PRIMARY | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | 030278
NY |