Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18124 | NH |
N | 111NI0900X | Internist | 18124 | NH |
N | 207R00000X | Internist | 230451 | MA |
N | 111NI0900X | Internist | 230451 | MA |
N | 207R00000X | Internist | 312610 | NY |
N | 111NI0900X | Internist | 312610 | NY |
N | 207RH0002X | Hospice and Palliative Medicine | 18124 | NH |
Y | 207RH0002X | Hospice and Palliative Medicine | 312610 | NY |
NPI | 1396786992 |
---|---|
Provider Name | Suzana Katarina Everett Makowski |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14626-4122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 02/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3108787 | (05) | NH |