Healthcare Provider Details

I. General information

NPI: 1861683963
Provider Name (Legal Business Name): SUHU NATURAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 GLEN COVE AVE
GLEN HEAD NY
11545-1593
US

IV. Provider business mailing address

997 GLEN COVE AVE
GLEN HEAD NY
11545-1593
US

V. Phone/Fax

Practice location:
  • Phone: 516-759-5916
  • Fax: 516-759-5946
Mailing address:
  • Phone: 516-759-5916
  • Fax: 516-759-5946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number891
License Number StateNY

VIII. Authorized Official

Name: NORMAN YEN SUHU
Title or Position: PRESIDENT
Credential: ND
Phone: 516-759-5916