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General NPI Number Information
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NPI Number | 1306336706
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Entity Type | Individual
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Provider Name | SAMANTHA SEIDOR
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Gender | Female
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 27 MOUNTAIN BLVD STE 6
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City | WARREN
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State | NJ
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Zip | 07059-5605
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Country | US
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Telephone | 973-978-5137
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Fax |
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Provider Business Mailing Address
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Address Line | 9 MOUNTAINVIEW LN
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City | WARREN
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State | NJ
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Zip | 07059-6710
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Country | US
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Telephone | 973-978-5137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA11564300
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License Number State | NJ
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