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NPI Code Detail

MEDICARE: HARY SUSEELAN M.D.

MEDICARE: HARY SUSEELAN M.D.
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
1207R00000XInternal Medicine Physician256391NY
2207RC0200XCritical Care Medicine (Internal Medicine) Physician256391NY
3207RP1001XPulmonary Disease Physician256391NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619298981
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARY SUSEELAN M.D.
Provider Business Mailing Address
First Line : 1351 ROUTE 55
Second Line : SUITE 200
City : LAGRANGEVILLE
State : NY
Zip : 12540-5108
Country : US
Telephone Number : 845-475-9661
Fax Number : 845-475-4993
Provider Business Practice Location Address
First Line : 4068 ALBANY POST RD
Second Line :
City : HYDE PARK
State : NY
Zip : 12538-3900
Country : US
Telephone Number : 845-229-2123
Fax Number : 845-229-6313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 09/13/2017

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