Provider Demographics
NPI:1982421962
Name:SAMILA, AIDEN JAMES
Entity type:Individual
Prefix:
First Name:AIDEN
Middle Name:JAMES
Last Name:SAMILA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-2052
Mailing Address - Country:US
Mailing Address - Phone:908-380-9321
Mailing Address - Fax:
Practice Address - Street 1:634 COLFAX AVE
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-2052
Practice Address - Country:US
Practice Address - Phone:908-380-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program