Provider Demographics
NPI:1053468470
Name:SZURKO, SUSAN A
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:SZURKO
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 1:454 STANLEY PL
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2520
Mailing Address - Country:US
Mailing Address - Phone:732-499-8179
Mailing Address - Fax:
Practice Address - Street 1:454 STANLEY PL
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2520
Practice Address - Country:US
Practice Address - Phone:732-499-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA00045900227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ43ZA00045900OtherSTATE LICENSE