Provider Demographics
NPI:1740394667
Name:GUO, SUQIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUQIN
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BENNINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-740-9888
Mailing Address - Fax:
Practice Address - Street 1:90 BERGEN STREET
Practice Address - Street 2:SUITE 6100 UMDNJ NJ MEDICAL SCHOOL OPHTHELMOLOGY
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-972-2031
Practice Address - Fax:973-972-2068
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06456100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7589204Medicaid
NJGU011047Medicare ID - Type Unspecified
NJ7589204Medicaid