Individual
KEVIN SUTTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
293 PASSAIC ST, PASSAIC, NJ 07055-5803
(973) 916-0002
(973) 371-2543
Mailing address
293 PASSAIC ST, PASSAIC, NJ 07055-5803
(973) 916-0002
(973) 371-2543
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01343800
NJ
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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