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General NPI Number Information
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NPI Number | 1447646872
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Entity Type | Individual
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Provider Name | NINA SUDA
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Gender | Female
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 170 KINNELON ROAD SUITE 28
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City | KINNELON
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State | NJ
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Zip | 07405
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Country | US
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Telephone | 973-838-1717
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Fax | 973-838-1775
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Provider Business Mailing Address
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Address Line | PO BOX 95000 LB#7550
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City | PHILADELPHIA
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State | PA
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Zip | 19195-7550
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Country | US
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Telephone | 844-362-1735
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Fax | 973-290-7495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 25MA11106600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 293447-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA11106600
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License Number State | NJ
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