Provider Demographics
NPI:1316468895
Name:SUSSMAN, SEAN ROSS (DO)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ROSS
Last Name:SUSSMAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:40 VILLAGE GREEN DR STE B
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3253
Mailing Address - Country:US
Mailing Address - Phone:856-467-7360
Mailing Address - Fax:856-467-5959
Practice Address - Street 1:40 VILLAGE GREEN DR STE B
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-3253
Practice Address - Country:US
Practice Address - Phone:856-467-7360
Practice Address - Fax:856-467-5959
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10777400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine