Individual
SUSAN SAMUDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-1834
(315) 464-4720
Mailing address
163 INTREPID LN STE 100, SYRACUSE, NY 13205-2548
(315) 469-1130
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
311167-01
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
311167-01
NY
207Q00000X
Family Medicine Physician
0116028374
VA
Other
Enumeration date
06/23/2015
Last updated
04/13/2023
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