Individual
SUSAN AMICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
62 SEGUINE AVE STE 2, STATEN ISLAND, NY 10309-3723
(718) 317-7740
(718) 948-1090
Mailing address
62 SEGUINE AVE STE 2, STATEN ISLAND, NY 10309-3723
(718) 317-7740
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003694
NY
213ES0131X
Foot Surgery Podiatrist
N003694
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00903599
—
NY
Enumeration date
07/31/2006
Last updated
02/13/2022
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