Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 170292 | NY |
Y | 208200000X | Surgeon | 170292 | NY |
Y | 208600000X | Surgeon | 170292 | NY |
NPI | 1174946073 |
---|---|
Provider Name | Susan Christine Mueller |
First Address | Newburgh, NY 12550-1230 |
Second Address | Newburgh, NY 12550-1230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2014 |
Last Update Date | 31/03/2017 |