Provider Demographics
NPI:1609872555
Name:EPSTEIN, SAMUEL E (DO)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:E
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 BEACON AVE
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2418
Mailing Address - Country:US
Mailing Address - Phone:609-597-6092
Mailing Address - Fax:609-597-7458
Practice Address - Street 1:1168 BEACON AVE
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2418
Practice Address - Country:US
Practice Address - Phone:609-597-6092
Practice Address - Fax:609-597-7458
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB51223207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
578229Medicare ID - Type Unspecified
E27352Medicare UPIN