Individual
DR. JEANNETTE A. SUJOVOLSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1116 43RD ST, NORTH BERGEN, NJ 07047-2712
(201) 330-2632
(201) 330-2638
Mailing address
1116 43RD ST, NORTH BERGEN, NJ 07047-2712
(201) 330-2632
(201) 330-2638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB08580200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08BBRLV
MEDICARE
NJ
Enumeration date
10/17/2006
Last updated
04/22/2015
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