Koelliker, Susan Lyn

Koelliker, Susan Lyn is an individual health care provider with primary practice located at 593 Eddy St , Providence RI 02903-4923. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Koelliker, Susan Lyn can be contacted via phone (401) 444-5174.

Contact Information

Primary practice address
593 Eddy St Providence RI 02903-4923
Phone: (401) 444-5174
Fax: (401) 921-9212
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 154179 Massachusetts
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD08865 Rhode Island

Profile Details

NPI number 1841288719
LBN Legal business name Koelliker, Susan Lyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Mar 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841288719 NPPES
Other 005220 BLUECHIP
Other 403111 BLUECHIP
Other 007004713 BLUECHIP
Other 1600203 BLUECHIP
Other 3199894 BLUECHIP
Other 720053201 BLUECHIP
Other 3199894 BLUECHIP
Other 7004715 BLUECHIP
Other 000000001988 BLUECHIP
Other 003111482 BLUECHIP
Other 008865 BLUECHIP
Other 007004715 BLUECHIP
Other 240171 BLUECHIP
Other 300067448 BLUECHIP

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