Individual
SAMANTHA ELLEN COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 BURRS RD STE A&B, WESTAMPTON, NJ 08060-5517
(609) 261-0240
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA11395800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
10/04/2024
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