Individual
DR. CHANG SAM SUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
998 CROOKED HILL RD BLDG 5, BRENTWOOD, NY 11717-1043
(631) 306-5750
(631) 306-5884
Mailing address
111 BEAVER DAM RD, BROOKHAVEN, NY 11719-9715
(631) 306-5750
(631) 306-5884
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
156595
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01907157
—
NY
Enumeration date
12/13/2006
Last updated
07/08/2007
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