Provider Demographics
NPI:1033414255
Name:SUESSLE, AMY E (DO)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:E
Last Name:SUESSLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1560
Mailing Address - Street 2:123 NORTH SEA ROAD -1560
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11969-1560
Mailing Address - Country:US
Mailing Address - Phone:631-276-2659
Mailing Address - Fax:
Practice Address - Street 1:349 MEETING HOUSE LN
Practice Address - Street 2:OLD TOWN MEDICAL VILLAGE
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5051
Practice Address - Country:US
Practice Address - Phone:631-377-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY259627-1204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM