Provider Demographics
NPI:1992422992
Name:MORCOS, SUZY SAMIR MIKHAIL
Entity type:Individual
Prefix:
First Name:SUZY
Middle Name:SAMIR MIKHAIL
Last Name:MORCOS
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 1:321 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835-1840
Mailing Address - Country:US
Mailing Address - Phone:908-725-8050
Mailing Address - Fax:
Practice Address - Street 1:321 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1840
Practice Address - Country:US
Practice Address - Phone:908-725-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04260200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist