Healthcare Provider Details

I. General information

NPI: 1164104907
Provider Name (Legal Business Name): DOLORES THERESA SUZANSKY APN, CRNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 10TH AVE
BETHLEHEM PA
18018-5123
US

IV. Provider business mailing address

217 10TH AVE
BETHLEHEM PA
18018-5123
US

V. Phone/Fax

Practice location:
  • Phone: 484-749-9155
  • Fax: 484-328-6373
Mailing address:
  • Phone: 484-749-9155
  • Fax: 484-328-6373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ14888500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: