Doctor Name: | DR. DOUGLAS DENNIS SAMUELS |
NPI Number: | 1902052046 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 355100153200 |
Business Practice Address: | 330 Schraalenburgh Rd Haworth, NJ - 07641 |
Business Phone Number: | 2013844111 |
Business Fax Number: | |
Mailing Address: | 330 Schraalenburgh Rd, HAWORTH |
State: | NJ |
Postal Code: | 07641 |
Phone Number: | 2013844111 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2008 |
NPI Last Update Date: | 08/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 355100153200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |