Provider Demographics
NPI:1578582599
Name:KURANT-CAMPBELL, SUZAN FAITH (DPM)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:FAITH
Last Name:KURANT-CAMPBELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592B SPRINGFIELD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1002
Mailing Address - Country:US
Mailing Address - Phone:908-232-1060
Mailing Address - Fax:908-233-4909
Practice Address - Street 1:592B SPRINGFIELD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1002
Practice Address - Country:US
Practice Address - Phone:908-232-1060
Practice Address - Fax:908-233-4909
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01843213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1490401Medicaid
NJ1490401Medicaid
NJ540288Medicare PIN