Healthcare Provider Details

I. General information

NPI: 1912061920
Provider Name (Legal Business Name): SUZANNE M. LOFTUS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 STATE ROUTE 183
STANHOPE NJ
07874-2646
US

IV. Provider business mailing address

7 VALLEY VIEW RD
LONG VALLEY NJ
07853-3132
US

V. Phone/Fax

Practice location:
  • Phone: 973-426-1640
  • Fax: 973-426-1641
Mailing address:
  • Phone: 973-426-1640
  • Fax: 973-426-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100320600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: