Individual
SUZANNE J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 E SUNRISE HWY, 208, LINDENHURST, NY 11757-2598
(631) 225-7200
(631) 930-9451
Mailing address
150 E SUNRISE HWY, 208, LINDENHURST, NY 11757-2598
(631) 225-7200
(631) 930-9451
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
154158-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00618497
—
NY
01
—
02186203
MEDICAID GROUP #
NY
01
—
W35021
MEDICARE GROUP #
NY
Enumeration date
07/03/2006
Last updated
10/07/2009
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