=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346246600
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN A SAMUEL MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2005
-----------------------------------------------------
Last Update Date | 05/16/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 UNION STREET SUITE 101
-----------------------------------------------------
City | ROBBINSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08691-4219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-890-6677
-----------------------------------------------------
Fax | 609-585-2520
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 PHEASANT RUN SUITE 128
-----------------------------------------------------
City | NEWTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18940-3439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-860-3344
-----------------------------------------------------
Fax | 215-860-8950
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 25MA04561700
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | MD039170E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------