# SAMUEL HS THE MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134679525
- **Authorized official:** SAMUEL THE MD (OWNER)
- **Authorized official phone:** (201) 343-6916

## Contact information

- **Practice address:** 130 ORIENT WAY STE BB, RUTHERFORD, NJ 07070-2145
- **Practice address phone:** (201) 343-6916
- **Practice address fax:** (201) 438-4227
- **Mailing address:** 130 ORIENT WAY STE BB, RUTHERFORD, NJ 07070-2145
- **Mailing address phone:** (201) 343-6916
- **Mailing address fax:** (201) 438-4227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | 25MA328000 | NJ | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 25MA08785100 | NJ | Yes |

## Other

- **Enumeration date:** 10/10/2016
- **Last updated:** 10/10/2016