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General NPI Number Information
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NPI Number | 1073787438
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Entity Type | Organization
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Legal Business Name | IRA J. SUTTON MD
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 77 QUAKER RIDGE RD SUITE 101
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-2808
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Country | US
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Telephone | 914-636-0077
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Fax | 914-636-5116
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Provider Business Mailing Address
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Address Line | 77 QUAKER RIDGE RD SUITE 101
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-2808
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Country | US
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Telephone | 914-636-0077
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Fax | 914-636-5116
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. IRA J SUTTON
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Credential | M.D.
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Telephone | 914-636-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 154341
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License Number State | NY
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