MEDICARE: DR. MARIANNE B SUTTON 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	208000000X	Pediatrics Physician	31348501	NY

General Provider Information

NPI Number	:	1790746758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIANNE B SUTTON MD

Provider Business Mailing Address
First Line	:	20 THE BLVD
Second Line	:
City	:	COLD SPRING
State	:	NY
Zip	:	10516-3136
Country	:	US
Telephone Number	:	508-498-2196
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 THE BLVD
Second Line	:
City	:	COLD SPRING
State	:	NY
Zip	:	10516-3136
Country	:	US
Telephone Number	:	508-498-2196
Fax Number	:

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	03/03/2022

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