Provider Demographics
NPI:1154747459
Name:RICE, SUZANNE ELIZABETH
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 KNICKERBOCKER RD
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-1113
Mailing Address - Country:US
Mailing Address - Phone:201-767-7466
Mailing Address - Fax:
Practice Address - Street 1:177 KNICKERBOCKER RD
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-1113
Practice Address - Country:US
Practice Address - Phone:201-767-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1609654374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide