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Individual

DR. SHU-SHAN MA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 518-5152
(718) 716-8242
Mailing address
1700 GRAND CONCOURSE, 14J, BRONX, NY 10457-7646
(718) 716-0104

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
190754
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02061672
NY
Enumeration date
09/24/2006
Last updated
09/22/2010
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