Provider Demographics
NPI:1275675340
Name:PRAGER, SUSAN HIRSH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:HIRSH
Last Name:PRAGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:HIRSH
Other - Last Name:PRAGER KRIEGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:49 DREW ROAD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990
Mailing Address - Country:US
Mailing Address - Phone:845-986-3371
Mailing Address - Fax:
Practice Address - Street 1:1160 HAMBURG TPKE
Practice Address - Street 2:#3
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-305-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2694103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist