Provider Demographics
NPI:1477075497
Name:SINGH, SAMANTHA N (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:N
Last Name:SINGH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 ARMSTRONG AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-2101
Mailing Address - Country:US
Mailing Address - Phone:201-333-8575
Mailing Address - Fax:201-333-8575
Practice Address - Street 1:506 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3712
Practice Address - Country:US
Practice Address - Phone:201-471-7012
Practice Address - Fax:201-471-7014
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00728300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily