Individual
SAMANTHA VEMULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
333 15TH ST, HOBOKEN, NJ 07030-3429
(201) 482-9770
(201) 482-9780
Mailing address
4 SILVER BIRCH CT, NEW HARTFORD, NY 13413-3913
(518) 956-3590
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA10606400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2016
Last updated
12/03/2019
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