Individual
SUSAN ELLEN PANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
32 VILLAGE SQ, GLEN COVE, NY 11542-2515
(516) 676-1111
(516) 676-1366
Mailing address
1 HOLLOW LN, SUITE 110, NEW HYDE PARK, NY 11042-1215
(516) 365-6666
(516) 365-2183
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
183672
NY
207KA0200X
Allergy Physician
183672
NY
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
183672
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01454H
GHI MEDICARE
NY
01
—
0447024006
CIGNA
NY
01
—
1049295
FIRST HEALTH
NY
01
—
1118556
UNITED HEALTHCARE
NY
01
—
183673
HIP
NY
01
—
2C0754
HEALTHNET
NY
01
—
5605676
AETNA US HEALTHCARE
NY
01
—
6100677
GHI
NY
01
—
90553
VYTRA
NY
01
—
95G741
BLUE CROSS BLUE SHIELD
NY
01
—
ON13091
MDNY
NY
01
—
P1107530
OXFORD
NY
Enumeration date
09/13/2005
Last updated
07/12/2011
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