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Individual

MRS. SUSAN MARIE POPOLO BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
1 CEDAR CREST VILLAGE DR, POMPTON PLAINS, NJ 07444-2100
(973) 831-3540
(973) 831-3503
Mailing address
813 MAIDEN CHOICE LN, CATONSVILLE, MD 21228-3679
(410) 402-2257

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NN105310
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0203335
NJ
01
52-2114204-0
HORIZON BCBS OF NJ
01
522114204001
TRICARE
01
83-14608
EVERCARE
Enumeration date
11/01/2006
Last updated
01/13/2012
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