Provider Demographics
NPI:1821203316
Name:NESHIN, SUSAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:F
Last Name:NESHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:685 NEPTUNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4118
Mailing Address - Country:US
Mailing Address - Phone:732-988-8877
Mailing Address - Fax:
Practice Address - Street 1:1200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5008
Practice Address - Country:US
Practice Address - Phone:732-988-8877
Practice Address - Fax:732-988-2572
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA041701002084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF97690Medicare UPIN