Healthcare Provider Details

I. General information

NPI: 1699738815
Provider Name (Legal Business Name): SUSAN M WRIGHT DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGH ST
BUFFALO NY
14203-1126
US

IV. Provider business mailing address

100 HIGH ST
BUFFALO NY
14203-1126
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-2282
  • Fax:
Mailing address:
  • Phone: 716-859-2282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number003344
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: