Provider Demographics
NPI:1366867202
Name:DOCTOR, SUZANNE HOAGLAND (PTA)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:HOAGLAND
Last Name:DOCTOR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:DOCTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 HIDDEN HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4841
Mailing Address - Country:US
Mailing Address - Phone:732-998-1660
Mailing Address - Fax:
Practice Address - Street 1:35 HIDDEN HARBOR DR
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4841
Practice Address - Country:US
Practice Address - Phone:732-998-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-01
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00281400225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant