Individual
SUSAN E JEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
30 BROAD ST FL 45, NEW YORK, NY 10004-2942
(212) 530-0630
Mailing address
1 EMBARCADERO CTR STE 1900, SAN FRANCISCO, CA 94111-3723
(415) 658-6791
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
007997
NY
363A00000X
Physician Assistant
007997-1
NY
363A00000X
Physician Assistant
PA9342
MA
363AM0700X
Medical Physician Assistant
Primary
007997
NY
Other
Enumeration date
07/05/2005
Last updated
06/17/2025
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