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General NPI Number Information
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NPI Number | 1356166631
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Entity Type | Organization
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Legal Business Name | LORRAINE SUTPHIN, LLC
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1159 ROUTE 12A
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City | PLAINFIELD
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State | NH
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Zip | 03781-5051
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Country | US
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Telephone | 908-894-3147
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Fax |
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Provider Business Mailing Address
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Address Line | 1159 ROUTE 12A
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City | PLAINFIELD
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State | NH
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Zip | 03781-5051
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Country | US
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Telephone | 908-894-3147
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORRAINE A SUTPHIN
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Credential | APRN
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Telephone | 908-894-3147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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