Provider Demographics
NPI:1114255478
Name:SUHAI, STEPHANIE NICOLE (RD)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:NICOLE
Last Name:SUHAI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PAUL STREET
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07438-9029
Mailing Address - Country:US
Mailing Address - Phone:973-647-9417
Mailing Address - Fax:
Practice Address - Street 1:1 PAUL STREET
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07438-9029
Practice Address - Country:US
Practice Address - Phone:973-647-9417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ998856133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered