Provider Demographics
NPI:1073812061
Name:RIFFEL, SUZANNE ELAINE (OD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ELAINE
Last Name:RIFFEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 ALCOVA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1551
Mailing Address - Country:US
Mailing Address - Phone:702-341-0255
Mailing Address - Fax:
Practice Address - Street 1:2075 FESTIVAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1446
Practice Address - Country:US
Practice Address - Phone:702-341-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2019-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV450152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV450OtherNEVADA STATE BOARD OF OPTOMETRY