Provider Demographics
NPI:1073393468
Name:SAMONTE, BEAU ADELBERTO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BEAU
Middle Name:ADELBERTO
Last Name:SAMONTE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 MAIN ST APT 10A
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2124
Mailing Address - Country:US
Mailing Address - Phone:570-371-8497
Mailing Address - Fax:
Practice Address - Street 1:575 MAIN ST APT 10A
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2124
Practice Address - Country:US
Practice Address - Phone:570-371-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program