Healthcare Provider Details

I. General information

NPI: 1295726404
Provider Name (Legal Business Name): SUSAN B BRESSMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQUARE EAST
NEW YORK NY
10003
US

IV. Provider business mailing address

PO BOX 95000-2445
PHILADELPHIA PA
19195-2445
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8888
  • Fax:
Mailing address:
  • Phone: 212-844-8379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number134668
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: