Provider Demographics
NPI:1366792228
Name:SUTOR KERR, SUSAN ELIZABETH (CPHT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:SUTOR KERR
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:ELIZABETH
Other - Last Name:SUTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1465 RUPP LN
Mailing Address - Street 2:
Mailing Address - City:UPPER BLACK EDDY
Mailing Address - State:PA
Mailing Address - Zip Code:18972-9770
Mailing Address - Country:US
Mailing Address - Phone:610-982-5708
Mailing Address - Fax:
Practice Address - Street 1:1465 RUPP LN
Practice Address - Street 2:
Practice Address - City:UPPER BLACK EDDY
Practice Address - State:PA
Practice Address - Zip Code:18972-9770
Practice Address - Country:US
Practice Address - Phone:610-982-5708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RW01642800183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician