Healthcare Provider Details

I. General information

NPI: 1538491212
Provider Name (Legal Business Name): JASON SUH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3628
US

IV. Provider business mailing address

1 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3628
US

V. Phone/Fax

Practice location:
  • Phone: 201-634-5353
  • Fax: 201-634-5444
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA09329700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: