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General NPI Number Information
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NPI Number | 1376704007
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Entity Type | Organization
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Legal Business Name | SUSAN E.PANES, D.O. P.C.
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 222 WESTCHESTER AVE SUITE 403
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City | WHITE PLAINS
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State | NY
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Zip | 10604-2906
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Country | US
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Telephone | 914-428-4748
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Fax | 914-946-8766
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Provider Business Mailing Address
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Address Line | 222 WESTCHESTER AVE SUITE 403
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City | WHITE PLAINS
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State | NY
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Zip | 10604-2906
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Country | US
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Telephone | 914-428-4748
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Fax | 914-946-8766
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. SUSAN ELLEN PANES
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Credential | D.O.
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Telephone | 914-428-4748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 183672
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License Number State | NY
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