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NPI Code Detail

MEDICARE: SAMANTHA SABBAN DO

MEDICARE: SAMANTHA SABBAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician25MB12274300NJ

General Provider Information

NPI Number : 1346700762
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA SABBAN DO
Provider Business Mailing Address
First Line : 1144 E RIDGEWOOD AVE FL 2
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3941
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1144 E RIDGEWOOD AVE FL 2
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3941
Country : US
Telephone Number : 201-336-0188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2019
Last Update Date : 07/23/2024

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Directions to “ SAMANTHA SABBAN DO” Practice Location

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