Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 6200 | NJ |
NPI | 1053518654 |
---|---|
Provider Name | Abraham Samansky |
First Address | Cranford, NJ 07016-2158 |
Second Address | Cranford, NJ 07016-2158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 08/07/2007 |