Individual
SUSAN RAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1031 MCBRIDE AVE, SUITE 210 D, WOODLAND PARK, NJ 07424-2559
(973) 812-9091
(973) 339-9040
Mailing address
40 MICHELLE WAY, PINE BROOK, NJ 07058-9446
(973) 812-9091
(973) 237-9053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA06609700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000576801
AMERICHOICE HMO
NJ
01
—
2K4791
HEALTHNET HMO
NJ
01
—
60005903
HORIZON NJ HEALTH HMO
NJ
05
—
8777209
—
NJ
01
—
P00075820
RAILROAD MEDICARE
NJ
Enumeration date
07/17/2005
Last updated
02/09/2012
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