Samantha E Boustani, MD
Internal Medicine in Lodi, New Jersey
1700413044- Practice location
- 160 Essex St, Ste 102, Lodi, NJ 07644-2709
- Phone
- 551-996-8111
- Fax
- —
- Last updated
- January 23, 2026
Samantha E Boustani is an Internal Medicine based in Lodi, NJ. Samantha E Boustani practices in Lodi, NJ and has the professional credentials of MD. The NPI Number for Samantha E Boustani is 1700413044 and holds a License No. 25MA12210800 (NJ). The current practice location address for Samantha E Boustani is 160 Essex St, Ste 102, Lodi, NJ 07644-2709 and can be reached out via phone at 551-996-8111.
Provider Profile Details
- NPI Number
- 1700413044
- Provider Name
- Samantha E Boustani
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 160 Essex St, Ste 102, Lodi, NJ 07644-2709
- Phone Number
- 551-996-8111
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 26, 2020
- Last Update Date
- January 23, 2026
- Certification Date
- January 23, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 160 Essex St
Ste 102
Lodi, NJ 07644-2709 - City
- Lodi
- State
- New Jersey
- Zip
- 07644-2709
- Phone Number
- 551-996-8111
Provider Business Mailing Address Details
- Address
- 331 Newman Springs RD
Bldg 2, Ste 220
Red Bank, NJ 07701-5688 - City
- Red Bank
- State
- NJ
- Zip
- 07701-5688
License Information
- License Number (1)
- 25MA12210800
- License State (1)
- NJ
- Taxonomy (1)
- Internal Medicine · 207R00000X · Primary
- License Number (2)
- 25MA12210800
- License State (2)
- NJ
- Taxonomy (2)
- Internal Medicine, Sports Medicine · 207RS0010X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Samantha E Boustani, MD?
The NPI number of Samantha E Boustani, MD is 1700413044. It was assigned on March 26, 2020 and is currently active in the NPPES registry.
What is the specialty of Samantha E Boustani, MD?
Samantha E Boustani, MD is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in NJ under license number 25MA12210800.
Where does Samantha E Boustani, MD practice?
The practice location is 160 Essex St, Ste 102, Lodi, NJ 07644-2709. The office can be reached at 551-996-8111 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1700413044 directly on the NPPES registry website.