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General NPI Number Information
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NPI Number | 1770571101
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Entity Type | Individual
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Provider Name | SUZANNE KOCHWESER ANDERSON MD
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Gender | Female
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 172 KING RD E
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City | ITHACA
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State | NY
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Zip | 14850-9403
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Country | US
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Telephone | 607-272-0212
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Fax | 607-277-3785
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Provider Business Mailing Address
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Address Line | 4435 SENECA RD
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City | TRUMANSBURG
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State | NY
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Zip | 14886-9201
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Country | US
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Telephone | 607-387-5707
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Fax | 607-387-4354
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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 | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 155383
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 155383
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License Number State | NY
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