Individual
SUSAN GEORGE MAUTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-0741
(973) 972-7597
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA03760300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2094606
—
NJ
Enumeration date
01/17/2007
Last updated
08/18/2009
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