Provider Demographics
NPI:1942433511
Name:PLAINE, SUZANNE ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:PLAINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2130 ROUTE 35 STE B216
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1010
Mailing Address - Country:US
Mailing Address - Phone:732-974-0228
Mailing Address - Fax:732-263-7938
Practice Address - Street 1:2130 ROUTE 35 STE B216
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:732-974-0228
Practice Address - Fax:732-263-7938
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08652100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0530972Medicaid