Provider Demographics
NPI:1467724815
Name:BLIESATH, SUZANNE (DVM)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:BLIESATH
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OLD WOLFE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-3213
Mailing Address - Country:US
Mailing Address - Phone:973-527-7700
Mailing Address - Fax:973-527-7699
Practice Address - Street 1:23 BROOK LAWN DR
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-6106
Practice Address - Country:US
Practice Address - Phone:973-527-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00447400174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian