Individual
SUSAN M DREISS-CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
5A MEDICAL PARK DR, POMONA, NY 10970-3516
(845) 362-0075
Mailing address
12 MALLORY LN, TAPPAN, NY 10983-1113
(845) 613-7658
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006895
NY
363AM0700X
Medical Physician Assistant
25MP00303300
NJ
Other
Enumeration date
07/08/2005
Last updated
01/25/2018
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