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General NPI Number Information
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NPI Number | 1154300911
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Entity Type | Individual
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Provider Name | SUSAN M SANTRY MD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 127E LINCOLN AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3208
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Country | US
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Telephone | 203-249-6767
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Fax | 203-531-1901
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Provider Business Mailing Address
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Address Line | PO BOX 8503
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City | PELHAM
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State | NY
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Zip | 10803-8503
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Country | US
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Telephone | 203-249-6767
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Fax | 203-531-1901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1705661
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License Number State | NY
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