Individual
MRS. SUSANNE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCPSYA
Contact information
Practice address
952 5TH AVE, 5C, NEW YORK, NY 10021-1740
(646) 610-1921
Mailing address
952 FIFTH AVENUE, 5C, NEW YORK, NY 10021
(646) 610-1920
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000629
STATE PSYCHOANALYTIC LISE
NY
Enumeration date
05/11/2007
Last updated
07/08/2007
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