Provider Demographics
NPI:1245838440
Name:WU, SUSAN J
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:WU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N STANWICK RD
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3610
Mailing Address - Country:US
Mailing Address - Phone:856-419-2734
Mailing Address - Fax:
Practice Address - Street 1:314 N STANWICK RD
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3610
Practice Address - Country:US
Practice Address - Phone:856-419-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044648R183500000X
NJ28RI02664600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist