Healthcare Provider Details

I. General information

NPI: 1740254234
Provider Name (Legal Business Name): SUSAN MARIE RICE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CENTRAL AVE SUITE 301
TARRYTOWN NY
10591-3350
US

IV. Provider business mailing address

1 CENTRAL AVE SUITE 301
TARRYTOWN NY
10591-3350
US

V. Phone/Fax

Practice location:
  • Phone: 914-631-3166
  • Fax: 914-631-4513
Mailing address:
  • Phone: 914-631-3166
  • Fax: 914-631-4513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN004426
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: