Provider Demographics
NPI:1184654998
Name:ESQUILIN, SUSAN COHEN (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:COHEN
Last Name:ESQUILIN
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:COHEN
Other - Last Name:ESQUILIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:38 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3440
Mailing Address - Country:US
Mailing Address - Phone:973-744-1720
Mailing Address - Fax:866-371-4675
Practice Address - Street 1:38 PARK ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3440
Practice Address - Country:US
Practice Address - Phone:973-744-1720
Practice Address - Fax:866-371-4675
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00174800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist