Provider Demographics
NPI:1790712966
Name:SAMUELS, ARTHUR MARTIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:MARTIN
Last Name:SAMUELS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1282
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1282
Mailing Address - Country:US
Mailing Address - Phone:201-837-2125
Mailing Address - Fax:
Practice Address - Street 1:1325 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2800
Practice Address - Country:US
Practice Address - Phone:201-837-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNOO4428213E00000X
NJ1925213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01158676Medicaid
NYP49681Medicare ID - Type Unspecified
NJT81559Medicare UPIN
NY01158676Medicaid
NY02954Medicare ID - Type UnspecifiedGHI-QUEENS,NY ONLY
NJ625034Medicare ID - Type Unspecified