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Individual

DR. SUSAN L. GOLDFARB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD,PC

Contact information

Practice address
1181 RIVER RD, TEANECK, NJ 07666-2015
(201) 692-1510
(201) 692-9840
Mailing address
1181 RIVER RD, TEANECK, NJ 07666-2015
(201) 692-1510
(201) 692-9840

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
22DI01311800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
038870
NEW YORK STATE LICENSE
NY
01
1285654780
INCORPORATED NPI NUMBER
NJ
Enumeration date
07/21/2006
Last updated
08/08/2012
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