Individual
GABRIELLE FAYTH SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
217 W MAIN ST, BOONTON, NJ 07005-1162
(973) 939-6215
(973) 290-8345
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10492600
NJ
Other
Enumeration date
04/14/2016
Last updated
10/26/2020
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