Provider Demographics
NPI:1598573206
Name:STARRS, SAMANTHA DIANE (PA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DIANE
Last Name:STARRS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:108 BILBY RD STE 303
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4174
Mailing Address - Country:US
Mailing Address - Phone:908-852-7770
Mailing Address - Fax:973-335-4681
Practice Address - Street 1:108 BILBY RD STE 303
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4174
Practice Address - Country:US
Practice Address - Phone:908-852-7770
Practice Address - Fax:973-335-4681
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00895800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant