Provider Demographics
NPI:1346337243
Name:NEIGHER, SUSAN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:S
Last Name:NEIGHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SUSSEX TPKE
Mailing Address - Street 2:SUITE 104C
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2974
Mailing Address - Country:US
Mailing Address - Phone:973-895-4422
Mailing Address - Fax:973-895-4419
Practice Address - Street 1:1201 SUSSEX TPKE
Practice Address - Street 2:SUITE 104C
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2974
Practice Address - Country:US
Practice Address - Phone:973-895-4422
Practice Address - Fax:973-895-4419
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI01337103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNE454160Medicare ID - Type UnspecifiedPSYCHOLOGIST