Basic Information
| Provider Information | |||||||||
| NPI: | 1770039729 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | ASHLEY | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 272 US HIGHWAY 206 | ||||||||
| Address2: | |||||||||
| City: | FLANDERS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078369081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739273034 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 272 US HIGHWAY 206 | ||||||||
| Address2: | |||||||||
| City: | FLANDERS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078369081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739273034 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2016 | ||||||||
| LastUpdateDate: | 08/30/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA01677500 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.