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NPI Code Detail

MEDICARE: SAMEH SCANDER MD

MEDICARE: SAMEH SCANDER MD
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
1207R00000XInternal Medicine Physician25MA10794900NJ
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1811427198
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMEH SCANDER MD
Provider Business Mailing Address
First Line : 59 POMONA AVE
Second Line :
City : FAIR LAWN
State : NJ
Zip : 07410-1315
Country : US
Telephone Number : 973-304-0130
Fax Number :
Provider Business Practice Location Address
First Line : 224 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2168
Country : US
Telephone Number : 973-942-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2017
Last Update Date : 09/03/2020

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