Individual
SU THET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
4422 3RD AVE FL 5, BRONX, NY 10457-2545
(718) 960-3730
Mailing address
4422 3RD AVE FL 2, BRONX, NY 10457-2545
(718) 960-9415
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
F421292-1
NY
367A00000X
Advanced Practice Midwife
Primary
F001977-01
NY
Other
Enumeration date
08/23/2014
Last updated
02/12/2020
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