Provider Demographics
NPI:1114761004
Name:DR SAMUEL MAPP GENERAL SURGEON LLC
Entity type:Organization
Organization Name:DR SAMUEL MAPP GENERAL SURGEON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-993-5040
Mailing Address - Street 1:1305 NOTTINGHILL LN
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-4015
Mailing Address - Country:US
Mailing Address - Phone:732-993-5040
Mailing Address - Fax:646-733-3950
Practice Address - Street 1:176 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1121
Practice Address - Country:US
Practice Address - Phone:732-993-5040
Practice Address - Fax:646-733-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty