Individual
SUZANNE DOUBRAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111
(215) 214-3940
(215) 214-1425
Mailing address
2450 W HUNTING PARK AVE # CAB2200, PHILADELPHIA, PA 19129-1302
(215) 214-3940
(215) 214-1425
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
25MA08185400
NJ
2084P0800X
Psychiatry Physician
Primary
MD466312
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0211427
—
NJ
01
—
P00919249
RR MCR PTAN
NJ
Enumeration date
09/29/2008
Last updated
02/12/2019
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