Individual
MIRIAM SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4697
(203) 863-3000
Mailing address
1735 WILLOW CT, FAR ROCKAWAY, NY 11691-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
023316
NY
Other
Enumeration date
04/03/2019
Last updated
05/02/2019
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