Healthcare Provider Details

I. General information

NPI: 1669402798
Provider Name (Legal Business Name): SUZANNE KRIGSMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE KARIMI

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 FRANKLIN TPKE VALLEY HEALTH MEDICAL GROUP
WALDWICK NJ
07463-1816
US

IV. Provider business mailing address

50 KINDERKAMACK RD
WOODCLIFF LAKE NJ
07677-8021
US

V. Phone/Fax

Practice location:
  • Phone: 201-447-3603
  • Fax:
Mailing address:
  • Phone: 201-746-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA07369100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: