Individual
MS. DIANE STARK SUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
10 FRANKLIN TURNPIKE, SECOND FLOOR, WALDWICK, NJ 07463
(201) 612-0550
Mailing address
19 SHADYSIDE DRIVE, WYCKOFF, NJ 07481
(201) 891-5148
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC00190100
NJ
163W00000X
Registered Nurse
Primary
26NR03997100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00114374
RAILROAD MEDICARE
—
Enumeration date
03/19/2007
Last updated
09/11/2025
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