| Ruby J Sampson Md, Inc | |
|
106 Valley St 1st Floor South Orange NJ 07079-2886 | |
| (973) 313-9300 | |
| (973) 313-2313 |
| Full Name | Ruby J Sampson Md, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 106 Valley St, South Orange, New Jersey |
| Authorized Official Name and Position | Anjela Hayes (OFFICE MANAGER) |
| Authorized Official Contact | 9733139300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ruby J Sampson Md, Inc 106 Valley St 1st Floor South Orange NJ 07079-2886 Ph: (973) 313-9300 | Ruby J Sampson Md, Inc 106 Valley St 1st Floor South Orange NJ 07079-2886 Ph: (973) 313-9300 |
| NPI Number | 1922316090 |
|---|---|
| Provider Enumeration Date | 09/22/2010 |
| Last Update Date | 09/22/2010 |
| Medicare PECOS PAC ID | 6002008240 |
|---|---|
| Medicare Enrollment ID | O20101007000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922316090 | NPI | - | NPPES |
| 3357805 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 45315 (New Jersey) | Primary |
| Provider Name | Ruby J Sampson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619982014 PECOS PAC ID: 1355533597 Enrollment ID: I20101007000102 |
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