Provider Demographics
NPI:1013211382
Name:SUZANNE STREFF, PLLC
Entity Type:Organization
Organization Name:SUZANNE STREFF, PLLC
Other - Org Name:SUZANNE STREFF, O.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STREFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-678-4395
Mailing Address - Street 1:9617 N METRO PKWY W
Mailing Address - Street 2:1000
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-1400
Mailing Address - Country:US
Mailing Address - Phone:602-678-4395
Mailing Address - Fax:602-678-4396
Practice Address - Street 1:9617 N METRO PKWY W
Practice Address - Street 2:1000
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-1400
Practice Address - Country:US
Practice Address - Phone:602-678-4395
Practice Address - Fax:602-678-4396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-31
Last Update Date:2014-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ899152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ143127Medicare PIN