Provider Demographics
NPI:1336247451
Name:SAMMARTINO, ROBERT A (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:SAMMARTINO
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 1:445 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:SUITE B-8
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2337
Mailing Address - Country:US
Mailing Address - Phone:856-589-7740
Mailing Address - Fax:856-256-0291
Practice Address - Street 1:445 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:SUITE B-8
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2337
Practice Address - Country:US
Practice Address - Phone:856-589-7740
Practice Address - Fax:856-256-0291
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB056891002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0658957000OtherAMERIHEALTH/KEYSTONE
NJ2190907Medicaid
NJ5152OtherOPERATING ENGINEERS
NJ2269417OtherAETNA PROVIDER #
NJ1118648OtherHORIZON MERCY NON-PAR #
NJ130022255OtherRAILROAD MEDICARE
NJ2190907Medicaid
NJ1118648OtherHORIZON MERCY NON-PAR #