Healthcare Provider Details

I. General information

NPI: 1952212300
Provider Name (Legal Business Name): SUSAN MONICA MALTESE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 CENTRAL AVE
NEW PROVIDENCE NJ
07974-1505
US

IV. Provider business mailing address

550 CENTRAL AVE
NEW PROVIDENCE NJ
07974-1505
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-2214
  • Fax: 908-522-0764
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number41YA00040900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: