Individual
MS. SUSAN TILLSLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
395 MAIN ST, HACKENSACK, NJ 07601-5806
(201) 646-0333
Mailing address
991 VALLEY RD, FRANKLIN LAKES, NJ 07417-1725
(201) 891-4413
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
26NO04665000
NJ
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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