Healthcare Provider Details

I. General information

NPI: 1881984177
Provider Name (Legal Business Name): SUZETTE BRIONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 233RD ST
BRONX NY
10466-2604
US

IV. Provider business mailing address

10954 110TH ST
SOUTH OZONE PARK NY
11420-1013
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-9009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number266088
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: