Provider Demographics
NPI:1558745109
Name:SULARSKI, SUZETTE J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:J
Last Name:SULARSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ST LAWRENCE WAY
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1231
Mailing Address - Country:US
Mailing Address - Phone:732-536-6550
Mailing Address - Fax:
Practice Address - Street 1:4251 ROUTE 9 N
Practice Address - Street 2:BUILDING 3, SUITE F
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8303
Practice Address - Country:US
Practice Address - Phone:732-675-2230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100544400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist