Individual
LAURI SUSIENKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 CORPORATE DR, BRIDGEWATER, NJ 08807-1265
(908) 306-8904
(908) 306-1206
Mailing address
55 CORPORATE DR, BRIDGEWATER, NJ 08807-1265
(908) 306-8904
(908) 306-1206
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03606300
NJ
183500000X
Pharmacist
PCT.0012708
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03606300
NJ PHARMACIST LICENSE
NJ
01
—
PCT.0012708
CT PHARMACIST LICENSE
CT
Enumeration date
06/20/2014
Last updated
06/20/2014
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