Provider Demographics
NPI:1780880096
Name:SUSSMANN, AMADO ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:AMADO
Middle Name:ROSS
Last Name:SUSSMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:579A CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5426
Mailing Address - Country:US
Mailing Address - Phone:732-390-0040
Mailing Address - Fax:732-390-1856
Practice Address - Street 1:483 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3610
Practice Address - Country:US
Practice Address - Phone:732-390-0040
Practice Address - Fax:732-390-1856
Is Sole Proprietor?:No
Enumeration Date:2007-06-23
Last Update Date:2013-07-12
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA091299002085R0202X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0298981Medicaid
NY03486835Medicaid
NY03486835Medicaid