Individual
DR. HOWARD SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
181 N BELLE MEAD RD, EAST SETAUKET, NY 11733-3495
(111) 111-1111
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208259
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02007472
—
NY
01
—
12V472
EMPIRE BC.BS
NY
01
—
7389156
AETNA
NY
Enumeration date
06/16/2006
Last updated
08/22/2013
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