Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 256820 | NY |
N | 208200000X | Surgeon | 224199 | MA |
N | 208600000X | Surgeon | 224199 | MA |
N | 208200000X | Surgeon | 25MA09125900 | NJ |
N | 208600000X | Surgeon | 25MA09125900 | NJ |
N | 2086X0206X | Surgical Oncologist | 256820 | NY |
Y | 2086X0206X | Surgical Oncologist | 25MA09125900 | NJ |
NPI | 1720085707 |
---|---|
Provider Name | Dr. Matthew Yongwon Suh |
First Address | New York, NY 10044-0213 |
Second Address | Newton, NJ 07860-9604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 06/04/2015 |