Individual
SUSAN RA PAEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
800 POLY PL, BROOKLYN, NY 11209-7104
(347) 512-1466
Mailing address
14710 41ST AVE, APT#2J, FLUSHING, NY 11355-1266
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
NO-05998-0
NY
213ES0131X
Foot Surgery Podiatrist
NO-05998-0
NY
Other
Enumeration date
09/27/2006
Last updated
02/21/2012
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