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NPI 1538515119

NPI 1538515119 : MS. CZARINA SARAH SAMANIEGO : JACKSON, NJ

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General NPI Number Information
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    NPI Number           |    1538515119
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    Entity Type          |    Individual 
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    Provider Name        |    MS. CZARINA SARAH SAMANIEGO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/12/2016
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    Last Update Date     |    12/30/2025
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Provider Practice Location Address
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    Address Line         |    178 W VETERANS HWY 
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    City                 |    JACKSON
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    State                |    NJ
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    Zip                  |    08527-3410
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    Country              |    US
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    Telephone            |    201-979-1336
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    175 BELGROVE DR 
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    City                 |    KEARNY
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    State                |    NJ
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    Zip                  |    07032-1507
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    Country              |    US
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    Telephone            |    201-979-1336
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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        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    15BC00081400
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    License Number State |    NJ
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