Healthcare Provider Details

I. General information

NPI: 1538652854
Provider Name (Legal Business Name): MRS. TUTU SUAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 BEVERLY AVE
EAST LANSDOWNE PA
19050-2708
US

IV. Provider business mailing address

120 BEVERLY AVE
EAST LANSDOWNE PA
19050-2708
US

V. Phone/Fax

Practice location:
  • Phone: 484-431-9808
  • Fax:
Mailing address:
  • Phone: 484-431-9808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: