Type | Person | [sources] | |||
---|---|---|---|---|---|
Name | FOX, SUSAN · Susan A Fox | [sources] | |||
Birth date | not available | [sources] | |||
Nationality | not available | [sources] | |||
Country | United States of America | [sources] | |||
First name | Susan | [sources] | |||
ID Number | DS037400 | [sources] | |||
Last name | Fox | [sources] | |||
Middle name | A | [sources] | |||
NPI | 1952661472 | [sources] | |||
Sector | DMD | [sources] | |||
Title | DMD | [sources] | |||
Address | 2300 WALNUT STREET, PHILADELPHIA, PA 19103 · Philadelphia, PA | [sources] | |||
Last change | Last processed | First seen |
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
Medical providers who are precluded from participation in the Medical Assistance Program
United States of America · DHS
us-medpa-ec043e99d3e6a952249434fe302ed22536b15a5f
· us-mednj-1bab4d2f36fbce508704acfc893d29194a901e70
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Sanctions | |||||
---|---|---|---|---|---|
Country | Authority | Program | Start date | End date | |
United States of America | New Jersey Office of the State Comptroller | - |
Address | ||
---|---|---|
Full address | Country | |
Philadelphia, PA | United States of America | |
2300 WALNUT STREET, PHILADELPHIA, PA 19103 |
United States of America | Department of Human Services | - | - |