Provider Demographics
NPI:1164162566
Name:JANISZ, SUSANNE NATALIE (MD)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:NATALIE
Last Name:JANISZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27155 CHARDON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1166
Mailing Address - Country:US
Mailing Address - Phone:440-585-6553
Mailing Address - Fax:
Practice Address - Street 1:27155 CHARDON RD STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1166
Practice Address - Country:US
Practice Address - Phone:440-585-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program