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NPI Code Detail

MEDICARE: DR. JONATHAN S. SUSSMAN MD

MEDICARE:  DR. JONATHAN S. SUSSMAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0001XClinical Cardiac Electrophysiology Physician25MA08057300NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194779801
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN S. SUSSMAN MD
Provider Business Mailing Address
First Line : PO BOX 416457
Second Line :
City : BOSTON
State : MA
Zip : 02241-6457
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 MADISON AVE
Second Line : BOX 5
City : MORRISTOWN
State : NJ
Zip : 07962-1956
Country : US
Telephone Number : 973-971-4261
Fax Number : 973-290-7253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 09/29/2016

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