Provider Demographics
NPI:1841538386
Name:STRONG, SUE ELLEN (LMT)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:ELLEN
Last Name:STRONG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-8803
Mailing Address - Country:US
Mailing Address - Phone:973-214-1881
Mailing Address - Fax:
Practice Address - Street 1:22 ELM ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8803
Practice Address - Country:US
Practice Address - Phone:973-214-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00337300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist