Provider Demographics
NPI:1164043790
Name:SAMANIEGO, CELINE-ANN TEH-CHING (RN)
Entity Type:Individual
Prefix:
First Name:CELINE-ANN
Middle Name:TEH-CHING
Last Name:SAMANIEGO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 BRIARCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1400
Mailing Address - Country:US
Mailing Address - Phone:201-336-2456
Mailing Address - Fax:
Practice Address - Street 1:781 BRIARCLIFF AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1400
Practice Address - Country:US
Practice Address - Phone:201-336-2456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY783091163W00000X
NJ26NR20188200163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse