Individual
BARRY SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 ENGLE ST, ENGLEWOOD, NJ 07631-1823
(201) 894-0400
(201) 894-1022
Mailing address
375 ENGLE ST, ENGLEWOOD, NJ 07631-1823
(201) 894-0400
(201) 894-1022
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA03498600
NJ
2086S0129X
Vascular Surgery Physician
25MA03498600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0882801
—
NJ
01
—
330001880
RAILROAD MEDICARE ID #
NJ
Enumeration date
09/20/2005
Last updated
04/09/2009
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