Individual
MADISON SUZANNA MAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
131 ROUTE 70 STE 100, MEDFORD, NJ 08055-9501
(609) 267-9400
Mailing address
131 ROUTE 70 STE 100, MEDFORD, NJ 08055-9501
(609) 267-9400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00726400
NJ
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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