Park, Susie

Park, Susie is an individual health care provider with primary practice located at 43 New Scotland Ave Dept Of Radiology Mc 113, Albany NY 12208-3412. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Radiology, which is considered as her primary health care specialty. Park, Susie can be contacted via phone (518) 262-3722.

Contact Information

Primary practice address
43 New Scotland Ave Dept Of Radiology Mc 113 Albany NY 12208-3412
Phone: (518) 262-3722
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X 267437 New York

Profile Details

NPI number 1114177300
LBN Legal business name Park, Susie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2008
Last updated Jan 13th, 2023 - about 3 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 1114177300 NPPES
New York MEDICAID 03649323

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