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Individual
SUSIE PAE
Active
Individual
SUSIE PAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08994600
NJ
207R00000X
Internal Medicine Physician
Primary
A106288
CA
207R00000X
Internal Medicine Physician
MD440676
PA
Other
Enumeration date
04/13/2009
Last updated
12/27/2016
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