Healthcare Provider Details

I. General information

NPI: 1578085072
Provider Name (Legal Business Name): SAMANTHA SING FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 NEW RD STE 1C
NORTHFIELD NJ
08225-1179
US

IV. Provider business mailing address

2106 NEW RD STE F1
LINWOOD NJ
08221-1053
US

V. Phone/Fax

Practice location:
  • Phone: 609-699-5750
  • Fax:
Mailing address:
  • Phone: 609-699-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ00717700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: