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General NPI Number Information
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NPI Number | 1871544460
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Entity Type | Individual
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Provider Name | SAMANTHA RENEE MCCARL DPT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3100 BRUNSWICK PIKE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2408
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Country | US
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Telephone | 609-912-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 30101 PALM CT
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-1293
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Country | US
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Telephone | 609-799-5681
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 40QA01175900
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License Number State | NJ
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