Provider Demographics
NPI:1053121988
Name:ARIEL SUSMAN
Entity type:Organization
Organization Name:ARIEL SUSMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-330-1930
Mailing Address - Street 1:6 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-3313
Mailing Address - Country:US
Mailing Address - Phone:954-330-1930
Mailing Address - Fax:
Practice Address - Street 1:106 STRAUBE CENTER BLVD STE F-119
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1449
Practice Address - Country:US
Practice Address - Phone:609-474-0614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)