Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 162431 | NY |
NPI | 1073589438 |
---|---|
Provider Name | Dr. Susan H Wasserman |
First Address | Great Neck, NY 11021 |
Second Address | Great Neck, NY 11021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E39099 | (02) |