Individual
MR. PETER D. SUTTILE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PA-C
Contact information
Practice address
PRINCETON UNIVERSITY HEALTH SERVICE, WASHINGTON ROAD- MCCOSH HEALTH CTR., PRINCETON, NJ 08544-1004
(609) 258-3141
(609) 258-1355
Mailing address
130 BURNET CRESCENT, ROBBINSVILLE, NJ 08691
(609) 258-3141
(609) 258-1355
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00000500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00000500
LICENCE
NJ
Enumeration date
04/12/2007
Last updated
07/08/2007
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