Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 226722 | NY |
N | 111NI0900X | Internist | 226722 | NY |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 226722 | NY |
NPI | 1053330332 |
---|---|
Provider Name | Dr. Susana Adela Ebner |
First Address | New York, NY 10032-3725 |
Second Address | Ny, NY 10032-3822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 10/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01634371 | (05) | NY |
F27655 | (02) | NY |