Healthcare Provider Details

I. General information

NPI: 1437352705
Provider Name (Legal Business Name): SUZANNE TORTORIELLO RN,NPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WARREN ST 1 ST FLOOR EAST WING
NEWARK NJ
07103-3535
US

IV. Provider business mailing address

225 WARREN ST 1 ST FLOOR EAST WING
NEWARK NJ
07103-3535
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-0974
  • Fax: 973-972-3832
Mailing address:
  • Phone: 973-972-0974
  • Fax: 973-972-3832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number26NN04408200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: