Individual
DR. COLLEEN STEPHANIE SURLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
632 BROADWAY PH, NEW YORK, NY 10012-2614
(347) 933-6246
Mailing address
64 BLEECKER ST # 151, NEW YORK, NY 10012-2410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
270474-1
NY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
270474
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/24/2009
Last updated
10/21/2021
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