Provider Demographics
NPI:1932140399
Name:MAGHERINI ROTHE, SUZANNE A (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:A
Last Name:MAGHERINI ROTHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:A
Other - Last Name:ROTHE-MAGHERINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:80 PAVILION AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6413
Mailing Address - Country:US
Mailing Address - Phone:732-963-0166
Mailing Address - Fax:732-229-0299
Practice Address - Street 1:80 PAVILION AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6413
Practice Address - Country:US
Practice Address - Phone:732-963-0166
Practice Address - Fax:732-229-0299
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07704300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0052841Medicaid
NJ0052841Medicaid
NYH74823Medicare UPIN