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SAMANTHA DERISO LPN
NPI 1790910131
Licensed Practical Nurse in Staten Island, NY

Active since May 28, 2009
1477 HYLAN BLVD, STATEN ISLAND, NY 10305(718) 979-6900 Get Directions Write a Review

NPPES record last updated: May 28, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Samantha Deriso Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA DERISO LPN (NPI 1790910131) is an individual licensed practical nurse in Staten Island, New York, licensed in New York (295075) and active in the NPI registry since May 2009.

NPPES Registry Identity

NPI1790910131
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameSAMANTHA DERISOCredential: LPN
Location Address1477 HYLAN BLVDStaten Island, NY 10305-1906
Mailing Address316 Adams AveStaten Island, NY 10306-5216 · (917) 495-9906
Phone(718) 979-6900
Sole ProprietorYes
Enumeration DateMay 28, 2009
✔ NPI 1790910131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 295075
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
1477 HYLAN BLVD, Staten Island, NY 10305
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER CALCAGNO LPN
Licensed Practical Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
FELICIA HASTINGS RN
Registered Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
CAROL VELAZQUEZ
Licensed Practical Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
EMELIA BARKER LPN
Licensed Practical Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
CARLA PETRULLO RN
Registered Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
WILLIAM PICCININNI RN
Registered Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
AUDREY SCOTT LPN
Licensed Practical Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900
FRANCINE BALK RN
Registered Nurse
1477 HYLAN BLVD
STATEN ISLAND, NY 10305
Richmond County (718) 979-6900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Deriso's NPI number?

The NPI number for Samantha Deriso is 1790910131. It was assigned to this individual provider in the NPPES registry on May 28, 2009.

Where is Samantha Deriso located?

Samantha Deriso practices at 1477 Hylan Blvd, Staten Island, NY 10305. The listed phone number is (718) 979-6900.

What is Samantha Deriso's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Samantha Deriso was last updated on May 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.