Healthcare Provider Details

I. General information

NPI: 1598251936
Provider Name (Legal Business Name): SAMANTHA CHMIEL-TOWLE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 COUNTY ROAD 519 STE 1
BELVIDERE NJ
07823-1900
US

IV. Provider business mailing address

480 ROYAL MANOR RD
EASTON PA
18042-8705
US

V. Phone/Fax

Practice location:
  • Phone: 908-847-3418
  • Fax: 908-847-3419
Mailing address:
  • Phone: 908-797-5789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00827400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: