Provider Demographics
NPI:1063279057
Name:SAM, MAGARET (RN)
Entity type:Individual
Prefix:MISS
First Name:MAGARET
Middle Name:
Last Name:SAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 ABBI RD
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-3536
Mailing Address - Country:US
Mailing Address - Phone:201-388-0494
Mailing Address - Fax:
Practice Address - Street 1:202 ABBI RD
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-3536
Practice Address - Country:US
Practice Address - Phone:201-388-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR1296800163WH0200X
NJ26NR12916800163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health