Basic Information
Provider Information
NPI: 1376548669
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMM-STAGER
FirstName: SUSAN
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: RPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 MADISON AVE
Address2: STE 205
City: MORRISTOWN
State: NJ
PostalCode: 079607305
CountryCode: US
TelephoneNumber: 9732921101
FaxNumber: 9732924149
Practice Location
Address1: 101 MADISON AVE
Address2: STE 205
City: MORRISTOWN
State: NJ
PostalCode: 079607305
CountryCode: US
TelephoneNumber: 9732921101
FaxNumber: 9732924149
Other Information
ProviderEnumerationDate: 06/15/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00622800NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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