Healthcare Provider Details

I. General information

NPI: 1316133689
Provider Name (Legal Business Name): SUSAN M AUSTIN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

553 CLINTON AVE
ALBANY NY
12206-2738
US

IV. Provider business mailing address

402 UNION ST
SCHENECTADY NY
12305-1119
US

V. Phone/Fax

Practice location:
  • Phone: 518-462-3047
  • Fax:
Mailing address:
  • Phone: 518-374-7555
  • Fax: 518-374-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN M AUSTIN
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 518-462-3047