Individual
SUSAN A. ANTONELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D. CCC-A/F-AAA
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000801-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04484126
—
NY
Enumeration date
08/27/2015
Last updated
10/06/2016
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