Individual
SUSAN PANNULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
525 E 68TH ST, ST 626/BOX 99, NEW YORK, NY 10021-4870
(212) 746-4776
(212) 746-6607
Mailing address
575 LEXINGTON AVE, 5THFL., NEW YORK, NY 10022-6102
(212) 590-5152
(212) 590-7800
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
176302
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01897158
—
NY
Enumeration date
07/15/2006
Last updated
09/14/2011
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