Individual
MISS SAMANTHA DISANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
141 BRIDGETON PIKE UNIT B, MULLICA HILL, NJ 08062-2615
(856) 291-8600
(856) 291-8610
Mailing address
PO BOX 7776, LANCASTER, PA 17601
(888) 985-2727
(856) 779-0211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR1252700
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ00595500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0550566
—
NJ
Enumeration date
10/05/2015
Last updated
11/13/2024
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