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Individual

DR. SUSAN MARIA ELRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
325 MEETING HOUSE LN BLDG 2, SUITE 301, SOUTHAMPTON, NY 11968-5087
(631) 283-4048
Mailing address
PO BOX 2340, SOUTHAMPTON, NY 11969-2340
(631) 283-2430

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
064446
CT
2084N0400X
Neurology Physician
Primary
248965
NY
2084N0400X
Neurology Physician
54401-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03488382
NY
01
036123112
STATE LICENSE
IL
Enumeration date
07/09/2008
Last updated
11/17/2022
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