Provider Demographics
NPI:1568642809
Name:HUSSAR, SUZANNE F (R PH)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:F
Last Name:HUSSAR
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BOULDER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-1703
Mailing Address - Country:US
Mailing Address - Phone:610-353-8262
Mailing Address - Fax:610-356-2948
Practice Address - Street 1:1 BOULDER CREEK LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-1703
Practice Address - Country:US
Practice Address - Phone:610-353-8262
Practice Address - Fax:610-356-2948
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP025935L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist