Provider Demographics
NPI:1588933642
Name:SAMUEL, MERLIN ARUN (PT)
Entity type:Individual
Prefix:MRS
First Name:MERLIN
Middle Name:ARUN
Last Name:SAMUEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MERLIN
Other - Middle Name:ANNY
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3701 W RADCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-3645
Mailing Address - Country:US
Mailing Address - Phone:303-794-6484
Mailing Address - Fax:
Practice Address - Street 1:3701 W RADCLIFF AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-3645
Practice Address - Country:US
Practice Address - Phone:303-794-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist