Individual provider Active NPI

Susanne M Markman, PH.D.

  • Psychologist
  • Teaneck, NJ
National Provider Identifier
1518017466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35S100205100 Issued in NJ
Practice address
175 Cedar LN
Suite 5
Teaneck, NJ 07666-4315
Phone
(201) 287-1574
Fax
(845) 639-7098
NPI assigned
Jan 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35S100205100 NJ Primary

Addresses

Primary practice location

175 Cedar LN
Suite 5
Teaneck, NJ 07666-4315

Mailing address

175 Cedar LN
Suite 5
Teaneck, NJ 07666-4315
Phone (201) 287-1574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602001051 NJ Practitioner - Clinical Psychologist 8628011459 Practice locations: Englewood, NJ; Woodland Park, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 Quarry Dr
Woodland Park, NJ 07424-4200
Phone (973) 837-6506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518017466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "SUITE 5",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-287-1574",
            "fax_number": "845-639-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "SUITE 5",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-287-1574",
            "fax_number": "845-639-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKMAN",
        "first_name": "SUSANNE",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100205100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.