Individual
DR. JOHN IVAN SUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 CLIFTON AVE, SUITE 102, CLIFTON, NJ 07013-2724
(973) 778-2083
(973) 778-1584
Mailing address
11 CHITTENDEN RD STE 102, CLIFTON, NJ 07013-4203
(201) 456-4251
(973) 778-1584
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA03777100
NJ
2080A0000X
Pediatric Adolescent Medicine Physician
MA037771
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223674880
HMO
NJ
05
—
3078302
—
NJ
Enumeration date
08/16/2005
Last updated
09/27/2024
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