Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 183672 | NY |
N | 207KA0200X | Allergist | 183672 | NY |
NPI | 1306831706 |
---|---|
Provider Name | Susan Ellen Panes |
First Address | New Hyde Park, NY 11042-1215 |
Second Address | Glen Cove, NY 11542-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 12/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01454H | GHI MEDICARE (01) | NY |
0447024006 | CIGNA (01) | NY |
1049295 | FIRST HEALTH (01) | NY |
1118556 | UNITED HEALTHCARE (01) | NY |
183673 | HIP (01) | NY |
2C0754 | HEALTHNET (01) | NY |
5605676 | AETNA US HEALTHCARE (01) | NY |
6100677 | GHI (01) | NY |
90553 | VYTRA (01) | NY |
95G741 | BLUE CROSS BLUE SHIELD (01) | NY |
G87278 | (02) | NY |
ON13091 | MDNY (01) | NY |
P1107530 | OXFORD (01) | NY |