Provider Demographics
NPI:1760927370
Name:SUH, DANIEL (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SUH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 FORT LEE RD
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-2229
Mailing Address - Country:US
Mailing Address - Phone:201-336-7275
Mailing Address - Fax:
Practice Address - Street 1:40 FORT LEE RD
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-2229
Practice Address - Country:US
Practice Address - Phone:201-336-7275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist