MEDICARE: DR. SUSAN BIEBER PH.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
1	103T00000X	Psychologist	009509-1	NY

General Provider Information

NPI Number	:	1932128469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN BIEBER PH.D.

Provider Business Mailing Address
First Line	:	840 BEECH DR
Second Line	:
City	:	NISKAYUNA
State	:	NY
Zip	:	12309-3027
Country	:	US
Telephone Number	:	518-370-4095
Fax Number	:	518-370-4095

Provider Business Practice Location Address
First Line	:	427 NEW KARNER RD
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-3839
Country	:	US
Telephone Number	:	518-377-4093
Fax Number	:	518-370-4095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/21/2022

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