Individual provider · Type 1 NPI

Samantha N. Fanok, PA-C

Surgical Physician Assistant · Manasquan, NJ

NPI number 1962040105 Active

Practice location

2315 Route 34 S
Manasquan, NJ 08736-1444

Call (732) 974-0404 Map

Fax (732) 449-4271

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X25MP00788600 (NJ)
Surgical Physician Assistant Primary 363AS0400X25MP00788600 (NJ)

Surgical Physician Assistant: Definition to come...

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About NPI 1962040105

Samantha N. Fanok, PA-C's National Provider Identifier is 1962040105, issued on Dec 18, 2019. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Manasquan, NJ. The record was last updated on Dec 9, 2024.