Provider Demographics
NPI:1679898795
Name:SAMPAYO, LUZ (MS)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:
Last Name:SAMPAYO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1815
Mailing Address - Country:US
Mailing Address - Phone:646-281-7563
Mailing Address - Fax:
Practice Address - Street 1:101 LAKE ST
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-1815
Practice Address - Country:US
Practice Address - Phone:646-281-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool