Most Relevant Information
Provider Data
| NPI Number: | 1003010091 |
| Provider Name: | SUSAN P CHRYSTAL MDIV |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP1600X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/13/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
16 MADISON AVE
MADISON
NJ
07940
Practice Location Phone/Fax
| Phone: | 9738220707 |
| Fax: |
Provider Mailing Location
129 HILLCREST AVE
SUMMIT
NJ
07901
Provider Mailing Phone/Fax
| Phone: | 9084036597 |
| Fax: |