Individual
SUZANNE M MARCELLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
30 PROSPECT AVE, FACULTY PRACTICE OFFICE, HACKENSACK, NJ 07601-1914
(201) 996-2816
Mailing address
21 WALNUT ST, OAKLAND, NJ 07436-2615
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00066700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311045
AMERIGROUP PIN
NJ
01
—
60026254
HORIZON NJ HEALTH
NJ
01
—
O86O88ZFPY
COGENT MEDICARE NUMBER
NJ
Enumeration date
06/21/2006
Last updated
08/10/2010
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