Provider Demographics
NPI:1447582408
Name:MCGETTIGAN, SUZANNE F (ACNP-BC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:F
Last Name:MCGETTIGAN
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WEST JIMMIE LEEDS ROAD
Mailing Address - Street 2:SUITES 11 AND 12
Mailing Address - City:GALLOWAY TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08205
Mailing Address - Country:US
Mailing Address - Phone:609-404-9966
Mailing Address - Fax:609-404-9967
Practice Address - Street 1:2500 ENGLISH CREEK AVENUE
Practice Address - Street 2:BLDG 200 STE 223
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-407-2243
Practice Address - Fax:609-593-9850
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00257900207RI0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0229245Medicaid