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General NPI Number Information
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NPI Number | 1740329929
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Entity Type | Organization
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Legal Business Name | SUSAN MARKEL, MD
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 17 LIBRARY LN
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City | SIMSBURY
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State | CT
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Zip | 06070-2109
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Country | US
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Telephone | 860-690-6305
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Fax |
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Provider Business Mailing Address
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Address Line | 17 LIBRARY LN
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City | SIMSBURY
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State | CT
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Zip | 06070-2109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. SUSAN GALE MARKEL
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Credential | M.D.
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Telephone | 860-690-6305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 022358
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License Number State | CT
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