Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 170875 | NY |
NPI | 1568517217 |
---|---|
Provider Name | Susan Schuval |
First Address | Stony Brook, NY 11790-0989 |
Second Address | East Setauket, NY 11733-4080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 24/04/2015 |