Active NPI
Susan Vanatta
- Psychiatry Physician
- Bridgeton, NJ
National Provider Identifier
1942050802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 26NR09363800
- Practice address
- 333 Irving Ave
Bridgeton, NJ 08302-2123 - Phone
- (856) 575-4371
- NPI assigned
- Mar 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 26NR09363800 | NJ | Primary |
Addresses
Primary practice location
333 Irving Ave
Bridgeton, NJ 08302-2123
Mailing address
5 Willow LN
Pilesgrove, NJ 08098-2426
Phone (609) 412-5981
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR09363800 | NJ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1942050802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 WILLOW LN",
"city": "PILESGROVE",
"state": "NJ",
"postal_code": "080982426",
"telephone_number": "609-412-5981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 IRVING AVE",
"city": "BRIDGETON",
"state": "NJ",
"postal_code": "083022123",
"telephone_number": "856-575-4371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANATTA",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "26NR09363800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.