Provider Demographics
NPI:1760927370
Name:SUH, DANIEL (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SUH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LOWELL CT
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6466
Mailing Address - Country:US
Mailing Address - Phone:917-257-8587
Mailing Address - Fax:
Practice Address - Street 1:883 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1704
Practice Address - Country:US
Practice Address - Phone:212-245-8469
Practice Address - Fax:212-586-1502
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist