Doctor Name: | LEAH C SUSSER |
NPI Number: | 1235405648 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 270820 |
Business Practice Address: | 525 E 68th St # 140 New York, NY - 100654870 |
Business Phone Number: | 2127463886 |
Business Fax Number: | |
Mailing Address: | 525 E 68th St # 140, NEW YORK |
State: | NY |
Postal Code: | 100654870 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/29/2012 |
NPI Last Update Date: | 08/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 270820 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |