Individual provider Active NPI

Diane Stark Suda, MSW

  • Registered Nurse
  • Waldwick, NJ
National Provider Identifier
1720102239
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR03997100 Issued in NJ
Practice address
10 Franklin Turnpike
Second Floor
Waldwick, NJ 07463
Phone
(201) 612-0550
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00190100 NJ
Registered Nurse 163W00000X 26NR03997100 NJ Primary

Addresses

Primary practice location

10 Franklin Turnpike
Second Floor
Waldwick, NJ 07463

Mailing address

19 Shadyside Drive
Wyckoff, NJ 07481
Phone (201) 891-5148

Other identifiers 1

IdentifierTypeStateIssuer
P00114374OtherRAILROAD MEDICARE

Other names 1

  • Miss Diane Stark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00190100NJMDClinical Social Worker
26NR03997100NJMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1720102239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SHADYSIDE DRIVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "07481",
            "telephone_number": "201-891-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FRANKLIN TURNPIKE",
            "address_2": "SECOND FLOOR",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "07463",
            "telephone_number": "201-612-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDA",
        "first_name": "DIANE",
        "middle_name": "STARK",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00190100",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR03997100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00114374",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "STARK",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waldwick, NJ

Sources for this page

Verify at the official NPI Registry.