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MR. SAMUEL EMMANUEL DICKERSON LPN
NPI 1902139447
Licensed Practical Nurse in Roosevelt, NY

Active since September 16, 2009
95 W GREENWICH AVE, ROOSEVELT, NY 11575(516) 481-3421(516) 665-3798 Get Directions Write a Review

NPPES record last updated: September 16, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Samuel Emmanuel Dickerson Lpn NPPES

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

MR. SAMUEL EMMANUEL DICKERSON LPN (NPI 1902139447) is an individual licensed practical nurse in Roosevelt, New York, licensed in New York (241150-1) and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1902139447
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameMR. SAMUEL EMMANUEL DICKERSONCredential: LPN
Location Address95 W GREENWICH AVERoosevelt, NY 11575-1035
Mailing Address95 W Greenwich AveRoosevelt, NY 11575-1035 · (516) 481-3421 · Fax (516) 665-3798
Phone(516) 481-3421
Fax(516) 665-3798
Sole ProprietorYes
Enumeration DateSeptember 16, 2009
✔ NPI 1902139447 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 · 241150-1
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.
95 W GREENWICH AVE, Roosevelt, NY 11575
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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 Samuel Dickerson's NPI number?

The NPI number for Samuel Dickerson is 1902139447. It was assigned to this individual provider in the NPPES registry on September 16, 2009.

Where is Samuel Dickerson located?

Samuel Dickerson practices at 95 W Greenwich Ave, Roosevelt, NY 11575. The listed phone number is (516) 481-3421.

What is Samuel Dickerson'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 Samuel Dickerson was last updated on September 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.