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General NPI Number Information
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NPI Number | 1275634347
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Entity Type | Organization
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Legal Business Name | RHONA S SUSSER M D P C
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 30 MERRICK AVE SUITE 112
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City | EAST MEADOW
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State | NY
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Zip | 11554-1579
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Country | US
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Telephone | 516-794-7079
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Fax | 516-794-7033
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Provider Business Mailing Address
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Address Line | 30 MERRICK AVE SUITE 112
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City | EAST MEADOW
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State | NY
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Zip | 11554-1579
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Country | US
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Telephone | 516-794-7079
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Fax | 516-794-7033
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. RHONA S SUSSER
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Credential | M.D.
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Telephone | 516-794-7079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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