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1497796262

NPI Code Detail

MEDICARE: LOUIS K SUSSMAN MD

MEDICARE: LOUIS K SUSSMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25MA09549700	NJ
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	226950	NY

General Provider Information

NPI Number	:	1497796262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS K SUSSMAN MD

Provider Business Mailing Address
First Line	:	5645 MAIN ST
Second Line	:	NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
City	:	FLUSHING
State	:	NY
Zip	:	11355-5045
Country	:	US
Telephone Number	:	718-670-1374
Fax Number	:	718-661-7745

Provider Business Practice Location Address
First Line	:	5645 MAIN ST
Second Line	:	NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
City	:	FLUSHING
State	:	NY
Zip	:	11355-5045
Country	:	US
Telephone Number	:	718-670-1374
Fax Number	:	718-661-7745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	10/03/2024

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Directions to “ LOUIS K SUSSMAN MD” Practice Location

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