Individual
DR. MICHELE F IANNUZZI-SUCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 SOUTH ST, MIDDLETOWN, NY 10940-6404
(845) 341-4124
Mailing address
115 SOUTH ST, MIDDLETOWN, NY 10940-6404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
227034-1
NY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
227034-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4142678
MVP
NY
Enumeration date
12/01/2005
Last updated
06/21/2016
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