Individual
DR. JAY SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 YOUNG AVE, SUITE 275, MOORESTOWN, NJ 08057-3130
(856) 291-8855
(856) 291-8844
Mailing address
3 IRONGATE LN, MEDFORD, NJ 08055-3511
(609) 953-0108
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
25MA05311000
NJ
207UN0901X
Nuclear Cardiology Physician
Primary
25MA05311000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004100785
AETNA
—
05
—
0602701
—
NJ
01
—
2K5353
HEALTHNET
—
01
—
BNS047
OXFORD
—
Enumeration date
03/07/2006
Last updated
01/27/2023
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