Provider Demographics
NPI:1518306521
Name:FOX, SAMUEL (SCD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 US HIGHWAY 22
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2560
Mailing Address - Country:US
Mailing Address - Phone:908-722-1022
Mailing Address - Fax:
Practice Address - Street 1:245 US HIGHWAY 22
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2560
Practice Address - Country:US
Practice Address - Phone:908-722-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00085100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist