Individual
SUSAN TAMAGNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
17 W RED BANK AVE STE 201, WOODBURY, NJ 08096-1630
(856) 536-1515
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00032600
NJ
363AM0700X
Medical Physician Assistant
MA-002428-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100727800
TPI MEDICAID GROUP
PA
01
—
597586
TPI MEDICARE GROUP
PA
01
—
CD4829
TPI RAILROAD MEDICARE GROUP
PA
Enumeration date
06/09/2006
Last updated
02/26/2021
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