MRS. SAMARA DEVA RUSSELL APRN NP-C NPI 1356622120

NPI Information

NPI: 1356622120
Provider Name: MRS. SAMARA DEVA RUSSELL, APRN, NP-C
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
400 VALLEY RD STE 105
MOUNT ARLINGTON, NJ
ZIP 07856
Phone: (973) 770-7101
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MRS. Samara Deva Russell, APRN, NP-C is an adult health nurse practitioner in Mount Arlington, NJ with 13 years of experience. MRS. Samara Deva Russell, APRN, NP-C NPI is 1356622120. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 VALLEY RD STE 105
MOUNT ARLINGTON, NJ
ZIP 07856-316
Phone: (973) 770-7101
Fax: (973) 770-7108

The NPI 1356622120 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2011 and was last updated on 8/4/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	26NJ0107800	NEW JERSEY	Yes
2	363LA2200X	Nurse Practitioner	Adult Health	004763	CONNECTICUT	No
3	363LG0600X	Nurse Practitioner	Gerontology	CAPRN00529	RHODE ISLAND	No
4	364SX0106X	Clinical Nurse Specialist	Occupational Health	4763	CONNECTICUT	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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