Organization Name: | JACQUELINE M SUTERA DPM PC |
NPI Number: | 1073688271 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN E DOERNER (BILLING MANAGER) |
Mailing Address: | 452 Old Hook Rd 2nd Floor Emerson |
State: | NJ US |
Postal Code: | 076301381 |
Phone Number: | 2015991336 |
Fax Number: | 2015991386 |
NPI Enumeration Date: | 11/22/2006 |
NPI Last Update Date: | 10/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 25MD00279500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |