Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA04095600 | NJ |
N | 2080P0208X | Pediatric Infectious Diseases | 25MA0409500 | NJ |
NPI | 1174501886 |
---|---|
Provider Name | Dr. Susan Hagen Morrison |
First Address | Belleville, NJ 07109-4154 |
Second Address | Belleville, NJ 07109-4154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 13/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2091607 | (05) | NJ |
E23756 | (02) | NJ |