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General NPI Number Information
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NPI Number | 1558369629
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Entity Type | Individual
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Provider Name | SUSAN D ENTMACHER MD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 703 E MAIN ST
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3082
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Country | US
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Telephone | 856-727-0900
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Fax | 856-231-8428
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Provider Business Mailing Address
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Address Line | 703 E MAIN ST
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3082
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Country | US
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Telephone | 856-727-0900
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Fax | 856-231-8428
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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 | 25MA04847800
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License Number State | NJ
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