MEDICARE: DR. JOY DEBBIE SUDLER M.D.

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	25MA05283300	NJ

General Provider Information

NPI Number	:	1538319447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOY DEBBIE SUDLER M.D.

Provider Business Mailing Address
First Line	:	28 COTTAGE LN
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-2303
Country	:	US
Telephone Number	:	973-376-1210
Fax Number	:	973-376-1242

Provider Business Practice Location Address
First Line	:	28 COTTAGE LN
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-2303
Country	:	US
Telephone Number	:	973-376-1210
Fax Number	:	973-376-1242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2008
Last Update Date	:	09/27/2008

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