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Individual

BETTY SUAZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
579 COURTLANDT AVE, BRONX, NY 10451-5013
(718) 485-2100
Mailing address
230 E 123RD ST APT 801, NEW YORK, NY 10035-2033
(646) 340-7752

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
VN92800D
NY
Enumeration date
09/24/2018
Last updated
10/26/2021
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