Individual
ANNA SUPONYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9920 4TH AVE, SUITE 206, BROOKLYN, NY 11209-8333
(718) 238-8373
(718) 238-8375
Mailing address
9920 4TH AVE, SUITE 206, BROOKLYN, NY 11209-8333
(718) 238-8373
(718) 238-8375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
229325-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02575588
—
NY
Enumeration date
07/26/2005
Last updated
07/08/2007
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