Individual
SUZANNE DORA WOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 GALWAY PL STE 300, TEANECK, NJ 07666-3640
(201) 833-9500
Mailing address
111 GALWAY PL STE 300, TEANECK, NJ 07666-3640
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
25MP00833100
NJ
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
05/15/2023
Last updated
01/26/2026
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