Physician Compare National (NPI:1134189459)

HEALTHCARE PROVIDER: SHIRLEY ANN DAVIS-SUSSER PSY.D

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1134189459
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739353590
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111114000630
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAVIS-SUSSER
	Individual professional last name
Provider First Name	SHIRLEY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	387 HOOKER AVE
	Group Practice or individual's line 1 address
City	POUGHKEEPSIE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	126033631
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8454718645
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y