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NPI Code Detail

MEDICARE: DR. ALYSSA SUSSMAN M.D.

MEDICARE:  DR. ALYSSA  SUSSMAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistME0071888FL

General Provider Information

NPI Number : 1073534517
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYSSA SUSSMAN M.D.
Provider Business Mailing Address
First Line : 2800 S SEACREST BLVD
Second Line : SUITE 220
City : BOYNTON BEACH
State : FL
Zip : 33435-7960
Country : US
Telephone Number : 561-742-3929
Fax Number : 561-742-3931
Provider Business Practice Location Address
First Line : 2800 S SEACREST BLVD
Second Line : SUITE 220
City : BOYNTON BEACH
State : FL
Zip : 33435-7960
Country : US
Telephone Number : 561-742-3929
Fax Number : 561-742-3931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ALYSSA SUSSMAN M.D.” Practice Location

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