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Individual

SUSAN NISSIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
288 RUES LN, EAST BRUNSWICK, NJ 08816-5699
(732) 257-6100
Mailing address
319 MAPLE ST, ATTN AVAZQUEZ, PERTH AMBOY, NJ 08861-4101
(732) 324-8200

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05385400
NJ

Other

Enumeration date
05/15/2008
Last updated
05/15/2008
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