MEDICARE: ESTHER SUH AGNP-BC

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	363LA2200X	Adult Health Nurse Practitioner	311124	NY
2	363LA2200X	Adult Health Nurse Practitioner	95038227	CA
3	363LG0600X	Gerontology Nurse Practitioner	311124	NY

General Provider Information

NPI Number	:	1740993351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER SUH AGNP-BC

Provider Business Mailing Address
First Line	:	156 WILLIAM ST RM 303
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-5307
Country	:	US
Telephone Number	:	201-448-0836
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 W 36TH ST FL 11
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-7936
Country	:	US
Telephone Number	:	201-448-0836
Fax Number	:

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

Provider Enumeration Date	:	12/28/2022
Last Update Date	:	04/29/2026

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