Individual
DR. SUSIE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
43 NEW SCOTLAND AVE, DEPT OF RADIOLOGY MC 113, ALBANY, NY 12208-3412
(518) 262-3722
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
267437
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03649323
—
NY
Enumeration date
09/24/2008
Last updated
01/13/2023
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