Provider Demographics
NPI:1376548669
Name:RAMM-STAGER, SUSAN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:RAMM-STAGER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MADISON AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7305
Mailing Address - Country:US
Mailing Address - Phone:973-292-1101
Mailing Address - Fax:973-292-4149
Practice Address - Street 1:101 MADISON AVE
Practice Address - Street 2:STE 205
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7305
Practice Address - Country:US
Practice Address - Phone:973-292-1101
Practice Address - Fax:973-292-4149
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00622800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ036766PCNMedicare ID - Type Unspecified