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General NPI Number Information
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NPI Number | 1922656552
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Entity Type | Individual
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Provider Name | JOSE LUIS SUAREZ TIONGKO MD
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Gender | Male
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1 COOPER PLZ
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City | CAMDEN
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State | NJ
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Zip | 08103-1461
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Country | US
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Telephone | 800-826-6737
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-3526
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Country | US
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Telephone | 347-722-1410
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Fax | 906-208-2273
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 318832
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 07517820
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License Number State | NY
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