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Individual

DR. SUSAN ELIZABETH SHIRATO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, CRNP

Contact information

Practice address
200 BOWMAN DR STE E385, VOORHEES, NJ 08043-9638
(856) 840-4534
(856) 762-2853
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 840-4534
(856) 762-2853

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00472800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0672122
NJ
01
1007278000
TPI PA MEDICAID GROUP
PA
01
597586
TPI GROUP MEDICARE NUMBER
PA
01
CD4829
TPI RAILROAD MEDICARE GROUP ID
PA
Enumeration date
02/18/2013
Last updated
10/17/2024
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