Individual
SAMSON G VIMALANANDA
Active
Individual
SAMSON G VIMALANANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA10657200
NJ
2084P0800X
Psychiatry Physician
D20273
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019
BSDC
—
01
—
096890
MHN
—
01
—
1023561
CIGN
—
01
—
150N131G
MBMD
—
01
—
221073
KAIS
—
01
—
253557
COMP
—
01
—
42225312
BSMD
—
01
—
461905000
MAGE
—
01
—
595882
MAMS
—
01
—
PVPB76641
APS
—
Enumeration date
06/02/2006
Last updated
07/28/2022
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