Provider Demographics
NPI:1881853802
Name:SUFFIN, DANIEL MATTHEW (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MATTHEW
Last Name:SUFFIN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1200 E RIDGEWOOD AVE
Mailing Address - Street 2:3 WEST / SUITE 303
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3957
Mailing Address - Country:US
Mailing Address - Phone:201-689-7755
Mailing Address - Fax:201-689-0521
Practice Address - Street 1:1200 E RIDGEWOOD AVE
Practice Address - Street 2:3 WEST / SUITE 303
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3957
Practice Address - Country:US
Practice Address - Phone:201-689-7755
Practice Address - Fax:201-689-0521
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2015-05-17
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB08144800207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine