Provider Demographics
NPI:1063650752
Name:MICHAEL SUHL, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL SUHL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-273-8700
Mailing Address - Street 1:450 SPRINGFIELD AVENUE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:908-273-8700
Mailing Address - Fax:908-273-1995
Practice Address - Street 1:450 SPRINGFIELD AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:908-273-8700
Practice Address - Fax:908-273-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ258092084N0400X
NY905122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3096700-01Medicaid
NJ461551Medicare PIN
NJC56296Medicare UPIN