Provider Demographics
NPI:1538652854
Name:SUAH, TUTU
Entity Type:Individual
Prefix:MRS
First Name:TUTU
Middle Name:
Last Name:SUAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BEVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2708
Mailing Address - Country:US
Mailing Address - Phone:484-431-9808
Mailing Address - Fax:
Practice Address - Street 1:120 BEVERLY AVE
Practice Address - Street 2:
Practice Address - City:EAST LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2708
Practice Address - Country:US
Practice Address - Phone:484-431-9808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty