Healthcare Provider Details

I. General information

NPI: 1346337243
Provider Name (Legal Business Name): SUSAN S. NEIGHER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SUSSEX TPKE SUITE 104C
RANDOLPH NJ
07869-2974
US

IV. Provider business mailing address

1201 SUSSEX TPKE SUITE 104C
RANDOLPH NJ
07869-2974
US

V. Phone/Fax

Practice location:
  • Phone: 973-895-4422
  • Fax: 973-895-4419
Mailing address:
  • Phone: 973-895-4422
  • Fax: 973-895-4419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberSI01337
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: