Doctor Name: | DR. SUSANA ADELA EBNER |
NPI Number: | 1053330332 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 226722-1 |
Business Practice Address: | 1150 St Nicholas Ave 2nd Fl Ny, NY - 100323822 |
Business Phone Number: | 2128515494 |
Business Fax Number: | 2128515493 |
Mailing Address: | 2828 Broadway, Apt#8d NEW YORK |
State: | NY |
Postal Code: | 100252244 |
Phone Number: | 2126653264 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 03/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 226722-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |