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Individual

DR. BRADLEY DAVID SUSSNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
151 KNOLLCROFT RD BLDG 143 # 116A, LYONS, NJ 07939-5001
(908) 647-0108
(908) 604-5253
Mailing address
8 WASHINGTON AVE, WARREN, NJ 07059-5726
(908) 561-0431

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
015455
NY
103TC0700X
Clinical Psychologist
Primary
35S100412600
NJ

Other

Enumeration date
07/28/2006
Last updated
07/08/2007
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