Individual
DR. BRIAN DIEVENDORF SUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
209 MANHATTAN AVE, APC C, UNION CITY, NJ 07087-5204
(917) 232-2458
Mailing address
209 MANHATTAN AVE, APC C, UNION CITY, NJ 07087-5204
(917) 232-2458
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA09314200
NJ
Other
Enumeration date
01/30/2006
Last updated
01/14/2026
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