Individual
MRS. MONA L SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8940
Mailing address
2821 RIVERSIDE AVE, MERRICK, NY 11566-4940
(516) 379-0114
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006070
NY
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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