Provider Demographics
NPI:1982194551
Name:DENOVILLE, SAMANTHA LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LYNN
Last Name:DENOVILLE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1 KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1292
Mailing Address - Country:US
Mailing Address - Phone:908-692-9788
Mailing Address - Fax:
Practice Address - Street 1:121 ROUTE 31 STE 1200
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5755
Practice Address - Country:US
Practice Address - Phone:908-237-4106
Practice Address - Fax:908-968-3181
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2022-07-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant