Provider Demographics
NPI:1699650192
Name:SUAREZ, JUSTINE (CPD)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:CPD
Other - Prefix:MRS
Other - First Name:JUSTINE
Other - Middle Name:CARMEN MARIA
Other - Last Name:CALLAHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPD
Mailing Address - Street 1:451 STATE ROUTE 42
Mailing Address - Street 2:
Mailing Address - City:SHANDAKEN
Mailing Address - State:NY
Mailing Address - Zip Code:12480-5701
Mailing Address - Country:US
Mailing Address - Phone:845-430-9947
Mailing Address - Fax:
Practice Address - Street 1:451 STATE ROUTE 42
Practice Address - Street 2:
Practice Address - City:SHANDAKEN
Practice Address - State:NY
Practice Address - Zip Code:12480-5701
Practice Address - Country:US
Practice Address - Phone:845-430-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula