Individual
SUSAN L MAIOCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
111 CENTRAL AVE, SAINT MICHAEL'S MEDICAL CENTER PRIMARYCARECLINIC1ST FL., NEWARK, NJ 07102-1909
(973) 877-5080
(973) 877-2718
Mailing address
111 CENTRAL AVE, SAINT MICHAEL'S MEDICAL CENTER PRIMARYCARECLINIC1ST FL., NEWARK, NJ 07102-1909
(973) 877-5080
(973) 877-2718
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO05261700
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00070900
NJ
Other
Enumeration date
05/11/2006
Last updated
04/08/2014
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