Botrous, Suzanne W

Botrous, Suzanne W is an sole proprietor health care provider with primary practice located at 185 Central Ave Ste 308 , East Orange NJ 07018-3318. She recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as her primary health care specialty. Botrous, Suzanne W can be contacted via phone (973) 678-3776.

Contact Information

Primary practice address
185 Central Ave Ste 308 East Orange NJ 07018-3318
Phone: (973) 678-3776
Fax: (973) 678-6065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X MA061272 New Jersey

Profile Details

NPI number 1992861116
LBN Legal business name Botrous, Suzanne W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992861116 NPPES
New Jersey MEDICAID 6381006

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