Organization
THE SAMRA GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUNISA NAZIROVA (OFFICE MANAGER)
(732) 739-2100
Entity
Organization
Contact information
Practice address
300 PERRINE RD, SUITE 331, OLD BRIDGE, NJ 08857-2871
(732) 727-8800
(732) 727-0955
Mailing address
300 PERRINE RD, SUITE 331, OLD BRIDGE, NJ 08857-2871
(732) 727-8800
(732) 727-0955
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086720
—
NJ
05
—
0152081
—
NJ
05
—
0152099
—
NJ
05
—
0480304
—
NJ
05
—
3155501
—
NJ
Enumeration date
10/03/2006
Last updated
04/03/2012
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