Provider Demographics
NPI:1740840099
Name:RICHTER, SAMANTHA JOYCE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JOYCE
Last Name:RICHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1256 WHITESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4134
Mailing Address - Country:US
Mailing Address - Phone:908-783-9881
Mailing Address - Fax:
Practice Address - Street 1:1 BUCCANEER PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5701
Practice Address - Country:US
Practice Address - Phone:813-870-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer