Individual
MS. SUSAN FEDORUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4504
(732) 836-4532
Mailing address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4504
(732) 836-4532
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NO07839100
NJ
Other
Enumeration date
07/27/2006
Last updated
10/23/2017
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