Individual
MS. SAMANTHA BUSSANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1140 ROUTE 72 W, MANAHAWKIN, NJ 08050-2412
(609) 597-6011
Mailing address
331 NEWMAN SPRINGS RD, BLDG 2, STE 220, RED BANK, NJ 07701-5688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00599300
NJ
363AM0700X
Medical Physician Assistant
PA031169
DC
Other
Enumeration date
08/17/2015
Last updated
05/02/2025
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