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General NPI Number Information
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NPI Number | 1578503405
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Entity Type | Individual
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Provider Name | SUZANNE HOLDCRAFT MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 84 ROUTE 31 N STE 103
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City | PENNINGTON
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State | NJ
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Zip | 08534-3605
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Country | US
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Telephone | 609-730-1771
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Fax | 609-730-1274
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Provider Business Mailing Address
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Address Line | 84 ROUTE 31 N STE 103
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City | PENNINGTON
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State | NJ
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Zip | 08534-3605
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Country | US
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Telephone | 609-730-1771
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Fax | 609-730-1274
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA04461100
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License Number State | NJ
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