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General NPI Number Information
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NPI Number | 1306823901
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Entity Type | Individual
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Provider Name | SUSAN W. BRONER M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 520 E 70TH ST # 607
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City | NEW YORK
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State | NY
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Zip | 10021-9800
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Country | US
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Telephone | 212-746-1162
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Fax |
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Provider Business Mailing Address
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Address Line | 520 E 70TH ST # 607
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City | NEW YORK
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State | NY
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Zip | 10021-9800
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Country | US
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Telephone | 917-626-4280
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 233633
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License Number State | NY
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